心脏瓣膜钙化的超声心动图特征与临床意义的分析  

Echocardiographic features and clinical significance of cardiac valvular calcification

作　　者：张琪[1] 韩建成[1] 谷孝艳[1] 陈倬[1] 赵映[1] 张烨[1] 何怡华[1] ZHANG Qi;HAN Jiancheng;GU Xiaoyan;CHEN Zuo;ZHAO Ying;ZHANG Ye;HE Yihua(Echocardiography Medical Center,Maternal-Fetal Medicine Center in Fetal Heart Disease,Beijing Anzhen Hospital,Capital Medical University,Bei-jing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]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心脏超声医学中心胎儿心脏病母胎医学中心,100029

出　　处：《心肺血管病杂志》2021年第9期963-966,983,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研发计划资助项目(2018YFC1002300);心血管疾病精准医学北京实验室(PXM2018_014226_000013)。

摘　　要：目的:探讨心脏瓣膜钙化的超声心动图特征及临床意义。方法:回顾分析2018年1月至2020年12月,北京安贞医院住院行超声心动图检查结果提示为二尖瓣环钙化(MAC)及主动脉瓣钙化(AVC)的患者552例,根据其二尖瓣环钙化及主动脉瓣钙化特征进行钙化评分,根据评分结果分为轻度钙化、中度钙化及重度钙化三组,比较三组间临床资料、超声心动图特征及冠状动脉介入手术情况。结果:重度钙化组低密度脂蛋白水平、TG水平高于轻度钙化组,差异有统计学意义(P<0.05)。重度钙化组左心房前后径明显大于轻中度钙化组,重度钙化组在冠脉病变数量、左主干病变占比、3支病变占比、PCI占比、冠状动脉移植比例较轻中度钙化组均明显升高,差异有统计学意义(P<0.05)。结论:二尖瓣环及主动脉瓣瓣膜钙化程度与左心房前后径、血脂水平及冠状动脉病变严重程度相关;根据MAC和AVC特征可得出心脏瓣膜钙化评分可简便快捷评估心脏瓣膜钙化程度,具有一定临床预测价值。Objective:To investigate the echocardiographic features and clinical significance of cardiac valve calcification.Methods:Retrospectively analyzed 552 patients with mitral annular calcification(MAC)and aortic valve calcification(AVC)who underwent echocardiography in Beijing Anzhen Hospital from January 2018 to December 2020.According to their characteristics of mitral annular calcification and aortic valve calcification,calcification score was performed.According to the score result,the patients were divided into three groups:mild calcification,moderate calcification and severe calcification.The clinical data,echocar-diographic characteristics and coronary interventional surgery among the three groups were compared.Results:The levels of LDL and triglyceride in the severe calcification group were higher than those in the mild calcifica-tion group,and the differences were statistically significant(P<0.05).The anterior and posterior diameter of the left atrium in the severe calcification group was significantly higher than that in the mild-moderate calcifica-tion group.The number of coronary artery lesions,the proportion of left main artery lesions,the proportion of three-vessel lesions,the proportion of PCI and the proportion of coronary artery bypass in the severe calcification group were significantly higher than those in the mild-moderate calcification group,with statistical significance(P<0.05).Conclusions:The degree of mitral ring and aortic valve calcification is correlated with the anterior and posterior diameter of the left atrium,the level of low density lipoprotein and triglyceride,and the severity of coronary artery disease.Cardiac valve calcification score can be obtained according to MAC and AVC characteristics,which can easily and quickly evaluate the degree of calcification of heart valve,and has certain clinical predictive value.

关 键 词：二尖瓣环钙化 主动脉瓣钙化 冠心病 

分 类 号：R54[医药卫生—心血管疾病]