二尖瓣位生物瓣置换术后瓣膜毁损的临床特征及超声诊断价值  

Clinical characteristics and echocardiographic diagnostic value in patients with valve damage after mitral valve replacement

作　　者：牛宝荣[1] 谷孝艳[1] 张涵[1] 王月丽[1] 崇梅[1] 李嵘娟[1] 何怡华[1] NIU Baorong;GU Xiaoyan;ZHANG Han;WANG Yueli;CONG Mei;LI Rongjuan;HE Yihua(Department of Echocardiography,Beijing Anzhen Hospital,Capital Medical University,Beijing 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,100029

出　　处：《心肺血管病杂志》2021年第11期1153-1156,1171,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:分析二尖瓣位生物瓣膜置换术后瓣膜毁损再次手术患者临床的资料及超声心动图表现,探讨生物瓣毁损的临床及超声心动图特征,为患者后续治疗提供诊疗依据。方法:回顾性分析北京安贞医院,二尖瓣位生物瓣膜置换术后瓣膜毁损患者76例的临床资料及超声心动图特征,均经再次手术加以证实。结果:76例患者,中位年龄为64.5岁,男性30例,女性46例。76例患者中再次手术原因:42例单纯性瓣膜关闭不全,18例单纯性瓣膜狭窄,11例瓣膜狭窄合并关闭不全,5例感染性心内膜炎合并关闭不全;76例患者两次手术的中位间隔时间为9.5年,其中年龄≤50岁患者中位间隔时间为10.0年,年龄51〜69岁患者的中位间隔时间为8.0年,年龄≤70岁患者中位间隔时间为12.0年;男性患者中位间隔时间7.0年,女性患者中位间隔时间为10.0年。结论:二尖瓣位生物瓣置换术后瓣膜毁损的原因较多且再次手术间隔的时间不同,间隔时间较短的瓣膜毁损主要原因是感染性心内膜炎,间隔时间较长的瓣膜毁损主要原因是瓣膜关闭不全,女性出现瓣膜毁损的间隔时间较男性患者间隔时间长(P=0.009),超声心动图能较准确的诊断并评估二尖瓣位生物瓣置换术后瓣膜毁损情况。Objective:To analyze the clinical data and echocardiographic features of patients with mitral bioprosthetic reoperation,to explore the clinical and echocardiographic features of biological valve damage,and to provide the basis for the follow-up treatment of patients.Methods:The clinical data and echocardiographic changes of 76 patients with mitral bioprosthetic valve replacement from Anzhen hospital were retrospectively analyzed.The result were confirmed by reoperation.The clinical characteristics and the key points of echocardiographic diagnosis of mitral bioprosthetic valve replacement were summarized.Results:Of the 76 patients,the mean age was 64.5 years,30 males and 46 females.The causes of 76 patients with mitral biopros-thetic reoperation as follows:42 patients with simple valvular insufficiency,18 patients with simple valvular stenosis,11 patients with stenosis and regurgitation,and 5 patients with valvular insufficiency with infective endocarditis.The length of intervals of the 76 patients was 9.5 years,the mean interval was 10.0 years for patients aged≤50 years,the mean interval was 8.0 years for patients aged 51 to 69 years,and 12.0 years for patients aged≤70 years.The mean interval was 7.0 years for men and 10.0 years for women.Conclusions:There are many causes of leaflet damage after mitral bioprosthetic valve replacement,and the length of intervals are different.The main causes of leaflet damage with shorter interval are infective endocarditis.The main causes of leaflet damage with longer interval are valve insufficiency.The interval of leaflet damage in female patients is longer than that in male patients.Echocardiography can accurately diagnose the damage of mitral valve leaflet after mi-tral valve replacement and provide the basis for patients to undergo valve.replacement again.

关 键 词：超声心动图 生物瓣毁损 间隔时间 

分 类 号：R54[医药卫生—心血管疾病]