心率控制与生物瓣膜衰败关系的初步探讨  

Relationship between heart rate and failure of biological valve

作　　者：徐志伟 石秋霞[2] 富智[1] 黄苏[1] XU Zhiwei;SHI Qiuxia;FU Zhi;HUANG Su(Department of Cardiac Surgery,Huaian First People’s Hospital,The Affifiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian 223000,China)

机构地区：[1]淮安市第一人民医院南京医科大学附属淮安第一医院心脏外科,223000 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所重症监护室

出　　处：《心肺血管病杂志》2020年第10期1222-1224,共3页Journal of Cardiovascular and Pulmonary Diseases

基　　金：南京医科大学附属淮安第一医院高层次人才科研启动经费(YGRX201914)。

摘　　要：目的:探讨心率与生物瓣膜衰败的关系,减慢心率能否延缓生物瓣膜的衰败。方法:回顾性分析1998年至2010年12年期间89例生物瓣膜置换病例随访资料,通过门诊、电话及信件方式随访,以基础心率75次/min为界分为:A组:基础心率<75次/min患者,B组:基础心率大于75次/min患者。评价其血压、心功能、超声心动图等资料及再手术率。结果:A组患者平均随访时间高于B组患者;超声心动图资料显示A组患者出现瓣膜撕裂穿孔及瓣叶钙化僵硬的比例明显低于B组患者;A组患者再手术率明显低于B组患者;二次手术术中探查也可见,A组患者出现三瓣叶同时撕裂的比例低于B组患者。结论:在不影响血压及心功能的基础上,通过控制心率在较低水平可以延缓生物瓣膜的衰败。Objective: To explore the relationship between heart rate and the failure of biological valves, whether slowing the heart rate can delay the failure of biological valves. Methods: Retrospective analysis of the follow-up data, which was recorded by outpatient, telephones and letters, of 89 cases of biological valve replacement. The patients were divided by basic heart rate: Group A: basic heart rate less than 75 beats per minute;Group B: basic heart rate greater than 75 beats per minute. Evaluate the blood pressure, cardiac function, echocardiography and reoperation rate. Results: The average follow-up time of patients in group A was higher than that of patients in group B;echocardiographic data showed that the proportion of patients with valve tear and perforation and stiffness of valve calcification were significantly lower in patients in group A;reoperation rate were also significantly lower in group A than in group B;exploration of reoperation also showed that patients in group A had a lower rate of simultaneous trilobal tear than those in group B. Conclusions: The failure of biological valve can be delayed by controlling heart rate at a low level, if not affecting blood pressure and heart function.

关 键 词：生物瓣膜 衰败 心率 

分 类 号：R54[医药卫生—心血管疾病]