二尖瓣环位移对主动脉瓣狭窄患者药物治疗效果的评估价值  

Application value of tissue mitral annular displacement in assessing curative effect of pharmacotherapy for patients with aortic stenosis

作　　者：纪淑姣[1] 李玉珍[1] 冯艳芬[1] 张莹莹[1] Ji Shujiao;Li Yuzhen;Feng Yanfen;Zhang Yingying(Department of Ultrasound,Henan Provincial Chest Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省胸科医院超声科,郑州450003

出　　处：《中国实用医刊》2018年第21期23-26,共4页Chinese Journal of Practical Medicine

摘　　要：目的 探讨二尖瓣环位移斑点组织追踪技术（TMAD）在主动脉瓣狭窄患者药物保守治疗中的应用价值.方法 收集2014年5月至2017年2月在河南省胸科医院住院治疗的主动脉瓣重度狭窄伴心功能衰竭患者23例,按照左心室有无心肌收缩储备分为两组,无心肌收缩储备的15例患者为A组,有心肌收缩储备的8例患者为B组,均行药物保守治疗,统计分析两组患者治疗前、治疗后1个月及6个月时二尖瓣环位移占左室长径百分比（TMAD Midpt％）及常规左室收缩功能参数的变化情况,并随访观察24个月.结果 两组患者治疗后1、6个月与治疗前相比,左室射血分数（LVEF）、每搏输出量（SV）、TMAD Midpt％均升高,差异有统计学意义（P〈0.05）;治疗后6个月与治疗后1个月比较,A组TMAD Midpt％减低,且差异有统计学意义（P〈0.05）,B组LVEF、SV、TMAD Midpt％均升高,但差异未见统计学意义（P〉0.05）.随访24个月,A、B两组患者死亡存活比相近.结论 TMAD Midpt％可作为评价主动脉瓣狭窄患者药物诊疗效果的敏感指标;无论有或无心肌收缩储备,药物保守治疗远期死亡情况均相似.Objective To investigate the value of tissue mitral annular displacement （ TMAD） tracing technique in pharmacotherapy for patients with aortic stenosis （ AS ） .Methods Twenty-three patients with severe aortic valve stenosis complicated by heart failure who were hospitalized in Henan Provincial Chest Hospital from May 2014 to February 2017 were selected .And they were divided into two groups, group A （15 cases without contractile reserve ） and group B （ 8 cases with contractile reserve ）, according to the morbidity of contractile reserve .All patients were given conservative medicine therapy . The TMAD Midpt％and parameters of conventional left ventricular systolic function before and 1 month and 6 months after treatment of the two groups were recorded and analyzed .And patients were followed up for 24 months.Results In the two groups, left ventricular ejection fraction （LVEF）, stroke volume （ SV） , TMAD Midpt％ at 1 month and 6 months after treatment were significantly higher than those before treatment （ P 〈0.05 ） .Compared with indicators 1 month after treatment , TMAD Midpt％ in group A were significantly lower at 6 months after treatment （P〈0.05）, and LVEF,SV,TMAD Midpt％in group B were increased at 6 months after treatment , but there was no statistical significance （ P〉0.05）.The survival rate of group A and was similar to that of group B in the 24-month follow-up. Conclusions The TMAD Midpt％parameter can be used as a sensitive index to evaluate the efficacy of drug treatment in AS patients .The long-term mortality is similar in drug conservative treatment , no matter patients are with myocardial contractile reserve or not .

关 键 词：二尖瓣环位移 超声心动图 主动脉瓣狭窄 收缩储备 

分 类 号：R540.45[医药卫生—心血管疾病] R542.5[医药卫生—内科学]