先天性二叶式主动脉瓣膜病变进展的危险因素分析  

Analysis of risk factors for progression of congenital bicuspid aortic valve lesions

作　　者：郑敏 阮燕萍[1] 何怡华[1] ZHENG Min;RUAN Yanping;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》2023年第4期347-351,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研究计划(项目号U21A20523)。

摘　　要：目的:随访二叶式主动脉瓣(bicuspid aortic valve,BAV)患者至少1年,评估主动脉瓣膜病变进展情况,并分析导致瓣膜病变进展的独立危险因素。方法:回顾2015年12月至2020年10月期间在我院就诊并使用经胸超声心动图确诊为BAV的患者,收集其临床特征及超声心动图参数,根据随访过程中其是否出现主动脉瓣狭窄或反流加重分为进展组和非进展组,使用单因素Logistic回归和多因素Logistic回归分析,筛选出导致瓣膜损害进展的独立危险因素。结果:三窦二叶型BAV(OR=2.346,95%CI:1.101~4.998,P=0.027)及男性(OR=2.178,95%CI:1.041~4.557,P=0.039)是瓣膜病变加重的危险因素,而合并冠心病(OR=0.155,95%CI:0.044~0.544,P=0.004)是瓣膜病变加重的保护因素。单纯反流加重组中男性比例较高(81.4%),单纯狭窄加重组中女性比例较高(64%)(P<0.001)。结论:男性及三窦二叶型BAV患者瓣膜损害更容易加重,在BAV随访过程中,应对这两类患者给高度关注,着重观察主动脉瓣膜损害情况,并建议其缩短随访周期。Objective:To follow up patients with bicuspid aortic valve(BAV)for at least 1 year to assess the progression of aortic valve lesions and to analyze independent risk factors.Methods:Patients diagnosed with BAV by transthoracic echocardiography between December 2015 and October 2020 were reviewed.Their clinical characteristics and echocardiographic parameters were collected.They were divided into progressive group and nonprogressive group according to whether the aortic stenosis or regurgitation exacerbated or not during follow-up.Univariate Logistic regression and multivariate Logistic regression analysis were used to screen the independent risk factors for progression of aortic valve lesions.Results:BAV of Type 1(OR=2.346,95%CI:1.101-4.998,P=0.027)and men(OR=2.178,95%CI:1.041-4.557,P=0.039)were risk factors for aortic valve lesion exacerbation,whereas combined with coronary artery disease(OR=0.155,95%CI:0.044-0.544,P=0.004)was the protective factor.Aortic regurgitation aggravation was significantly more common in men(81.4%)whereas women(64%)presented more often with Aortic stenosis,with P<0.001.Conclusions:BAV of和type 1 and men are more likely to have exacerbation of aortic valve lesions and more attention should be given for these patients during follow-up and the follow-up period should be shorter.

关 键 词：先天性二叶式主动脉瓣畸形 危险因素 LOGISTIC回归分析 随访 

分 类 号：R54[医药卫生—心血管疾病]