超声检查在老年退行性心瓣膜病中的价值评估  

Evaluation the value of ultrasound diagnosis in senile degenerative valvular heart disease

作　　者：王蕾 钟卫华 廖丽娟 WANG Lei;ZHONG Weihua;LIAO Lijuan(Department of Ultrasound,Jinggangshan University Hospital,Ji'an,Jiangxi,343000,China)

机构地区：[1]井冈山大学附属医院超声科,江西吉安343000

出　　处：《当代医学》2023年第34期163-165,共3页Contemporary Medicine

摘　　要：目的探究超声检查在老年退行性心瓣膜病中的应用价值。方法回顾性分析2019年1月至2021年3月井冈山大学附属医院收治的64例疑似老年退行性心瓣膜病患者的临床资料,确诊前均开展超声检查诊断,分析超声检查老年退行性心瓣膜病的确诊率及诊断价值(诊断准确率、特异度与灵敏度)。结果64例疑似老年退行性心瓣膜病患者,经综合检查确诊50例,其中包括二尖瓣病变(单纯)12例,主动脉瓣病变(单纯)15例,主动脉与二尖瓣病变合并11例,主动脉病变累及无冠瓣12例。超声检查检出老年退行性心瓣膜病49例,确诊47例,确诊率为73.44%,其中二尖瓣病变(单纯)12例,主动脉瓣病变(单纯)14例,主动脉与二尖瓣病变合并10例,主动脉病变累及无冠瓣11例。超声检查老年退行性心瓣膜病的诊断准确率为92.19%,灵敏度为94.00%,特异度为85.71%。超声检查影像学表现:收缩期出现高速频谱,以蓝色为主,并出现五彩镶嵌射流,判定为主动脉瓣狭窄;舒张期出现正向的高速频谱,血流信号呈五彩镶嵌,判定为主动脉瓣出现关闭不全;超声检查发现正向频谱,舒张期出现红色的明亮象或征象以红色为主,判定为二尖瓣狭窄;收缩期出现血流负向频谱,射流的方向沿着房壁射流或向中心射流,心尖的四腔收缩期从左心室走行,并以蓝色为主,判定为二尖瓣处于关闭不全。结论超声检查可提高老年退行性心瓣膜病检出率与诊断准确率,通过超声可了解血流信号,并在超声图像下观察病情,为医生治疗方案的制定提供一定的依据,值得临床推广应用。Objective To explore the effect of ultrasound diagnosis and the effect on the detection rate in the diagnosis of senile degenerative heart valve disease.Methods The clinical data of 64 cases of elderly patients with suspected degenerative valve disease admitted to Jinggangshan University Hospital from January 2019 to March 2021 were retrospectively analyzed,and they underwent ultrasound examination before diagnosis,and evaluated the detection rate and diagnostic value of ultrasound diagnosis of elderly degenerative valve disease(coincidence rate,specificity and sensitivity).Results Among elderly 64 patients with suspected degenerative heart valve disease,50 patients were diagnosed by comprehensive ex-amination,including 12 cases of mitral valve lesions(pure),15 cases of aortic valve lesions(pure),11 cases of combined aortic and mitral valve le-sions,and 12 cases of aortic disease involvement without coronary valve.49 cases were detected by ultrasound examination,and 47 cases were diag-nosed as elderly degenerative heart valve disease,with the detection rate of 73.44%,among them,there were 12 cases of mitral valve disease(pure),14 cases of aortic valve disease(pure),10 cases of combined aortic and mitral valve lesions,and 11 cases of aortic disease involving without coro-nary valve.The diagnostic accuracy,sensitivity and specificity of ultrasound in elderly patients with degenerative heart valve disease were 92.19%,94.00%and 85.71%,respectively.Imaging findings of ultrasound examination:in the systolic period,high speed spectrum appears in systole,mainly blue,and colorful mosaic jet appeared,which was judged to be the main aortic valve stenosis;in the diastole period,positive high speed spectrum ap-pears,and the blood flow signal were multicolored,which determined that the main artery valve had insufficiency;the positive spectrum was found by ultrasound examination,and red bright image,or diastolic signs were mainly red in the diastole period,which was determined to be mitral steno-sis;the negative spectrum of blo

关 键 词：超声 老年退行性心瓣膜病 诊断 特异度 灵敏度 超声图像 

分 类 号：R54[医药卫生—心血管疾病]