超声心动图对冠心病合并重度缺血性二尖瓣反流治疗的近期疗效分析  

Analysis of the short-term therapeutic effect of coronary heart disease complicated with severe ischemic mitral regurgitation by echocardiography

作　　者：于岩 曹军英 于馨 郭晓婧 YU Yan;CAO Jun-ying;YU Xin;GUO Xiao-jing(Department of Ultrasound,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院超声诊断科,辽宁沈阳110016

出　　处：《中国临床医学影像杂志》2023年第4期246-249,共4页Journal of China Clinic Medical Imaging

基　　金：辽宁省重点研发计划(2022JH2/10300122)。

摘　　要：目的:利用超声心动图分析重度缺血性二尖瓣反流(IMR)手术前后的治疗效果,并探讨其对治疗策略的影响。方法:选取北部战区总医院收治的同时行冠状动脉移植术及二尖瓣手术的96例患者为研究对象。所有患者通过术前药物规范治疗3~4周后,二尖瓣反流无明显变化者(仍为中度以上反流)58例为A组,从重度二尖瓣反流恢复为中度以下反流者38例为B组。收集2组患者的临床资料及术前、术后1月的超声心动图数据。结果:两组患者术前超声数据进行比较,只有LVEDd及LVEDV有统计学意义(P<0.05)。两组患者术后1月分别与术前超声数据对比,A组的LVEDd、Sm’、St’、LVEDV、SPAP有统计学意义(P<0.05),B组术后1月的超声数据均有显著性差异(P<0.05)。结论:冠心病合并重度IMR进行规范的术前药物调整治疗后,部分患者IMR可得到一定程度的改善,有效逆转左室重构,从而优化外科治疗方式,改善患者术后心脏功能恢复,超声心动图可以诊断和评估IMR的预后和调整合理的治疗策略来给临床提供参考。Objective:To analyze the ther apeutic effect of severe ischemic mitral regurgitation(IMR)before and after surgery by echocardiography,and to explore its influence on the treatment strategy.Methods:A total of 96 patients who underwent coronary artery transplantation and mitral valve surgery at the same time were selected as the study subjects.After 3~4 weeks of preoperative drug treatment,58 patients with no significant change in mitral regurgitation(still above moderate regurgitation)were assigned to group A,and 38 patients with recovery from severe mitral regurgitation to below moderate regurgitation were assigned to group B.Clinical data and echocardiography data before and one month after operation were collected.Results:Comparison of preoperative ultrasound data between the two groups showed that only LVEDd and LVEDV had statistical significance(P<0.05).Comparison of preoperative and postoperative ultrasound data between the two groups showed that LVEDd,Sm’,St’,LVEDV and SPAP in group A were statistically significant(P<0.05),while the ultrasound data in group B were significantly different one month after surgery(P<0.05).Conclusion:Coronary heart disease with severe IMR standard preoperative medication adjustments after treatment,some patients IMR can be improved to some extent,effective reverse left ventricular remodeling,so as to optimize surgical treatment,improve cardiac function after surgery recovery,echocardiography can diagnose and evaluate the prognosis of IMR and adjust the reasonable treatment strategies to provide reference to the performer.

关 键 词：冠心病 二尖瓣闭锁不全 超声心动描记术 多普勒 彩色 

分 类 号：R543.3[医药卫生—心血管疾病] R540.45[医药卫生—内科学]