实时三维经食管超声心动图定量分析主动脉瓣反流患者主动脉根部解剖结构  

Quantificantion analysis of aortic root anatomical structure in aortic regurgitation patients by real-time three-dimensional transesophageal echocardiography

作　　者：付昕[1] 熊名琛 曲绍辉 吴家荣 田家玮[1] FU Xin;XIONG Mingchen;QU Shaohui;Wu Jiarong;TIAN Jiawei(Department of Ultrasound Medicine,the Second Affiliated Hospital,Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,哈尔滨市150086 [2]中国台湾台北市振兴医院心脏血管医学中心

出　　处：《临床超声医学杂志》2020年第3期180-183,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用实时三维经食管超声心动图(RT-3D-TEE)定量分析主动脉瓣反流(AR)患者主动脉根部解剖参数,筛选其中对AR影响最大的参数。方法选取我院择期接受主动脉瓣置换术的中至重度AR患者42例(AR组)和无AR的心脏疾病患者30例(对照组),应用RT-3D-TEE获取两组主动脉瓣环、主动脉窦部及窦管结合部水平面的主动脉根部内径(AAD、SOVD、STJD),主动脉根部面积(AAA、SOVA、STJA),主动脉根部周长(AAC、SOVC、STJC)。比较两组上述各参数;Logistic回归分析两组间存在差异的参数,筛选其中对AR影响显著的参数,并绘制相应参数的受试者工作特征(ROC)曲线,分析其判定AR的敏感性和特异性。结果 AR组SOVD、STJD、AAA、SOVA、STJA、AAC、SOVC、STJC均较对照组增大,差异均有统计学意义(均P<0.05);仅AAD两组比较差异无统计学意义。多因素逻辑回归模型逐步筛选出STJA和STJC对AR有显著影响(P=0.002、0.005)。ROC曲线分析显示,STJA和STJC截断值为7.165 mm2、9.3 mm时,判定AR的敏感性、特异性分别为69.8%、95.0%和74.4%、95.0%,曲线下面积分别为0.867、0.885。结论 AR时,主动脉瓣环、主动脉窦部及窦管结合部3个水平面主动脉根部参数增大程度不同,其中窦管结合部水平面的面积及周长变化显著,是导致AR的重要因素。Objective To quantitatively analyze the aortic root anatomical characteristics,and to screen the()dimensional transesophageal echocardiography(RT-3 D-TEE)in AR patients.MethodsForty-two patients with AR were enrolled in AR group and 30 patients without AR were enrolled in control group.Parameters of the aortic root including root diameter(AAD,SOVD,STJD),root area(AAA,SOVA,STJA),root circumference(AAC,SOVC,STJC)were acquired by RT-3 D-TEE and compared between two groups.All parameters were analyzed by the Logistic regression,the parameters that have a significant effect on AR were selected and the receiver operating characteristic(ROC)curve of corresponding parameter was drawn to analyze the sensitivity and specificity of AR.ResultsCompared with the control group,SOVD,STJD,AAA,SOVA,STJA,AAC,SOVC,STJC in AR group were increased significantly(all P<0.05),while only ADD had no statistical differences.STJA and STJC had significant influence on AR by multivariable Logistic regression(P=0.002,0.005).The ROC curve analysis showed that taking STJA was 7.165 mm2,STJC was 9.3 mm as cutoff value,the sensitivity and specificity were 69.8%,95.0% and74.4%,95.0%,the area under ROC curve were 0.867 and 0.885,respectively.ConclusionThe aortic root parameters of thethree levels of the aortic annulus,aortic sinus,and sinus canal junction increase differently.Among them,the horizontal area and parameter of sinus canal junction change significantly,which are important factors leading to AR.

关 键 词：超声心动描记术 经食管 三维 实时 主动脉瓣反流 主动脉根部 解剖结构 

分 类 号：R540.45[医药卫生—心血管疾病] R542.52[医药卫生—内科学]