风湿性二尖瓣成形手术疗效的影响因素分析  

Analysis of influencing factors on the outcome of rheumatic mitral valve repair

作　　者：贾崧淏 王茂舟 韩杰[1] 姜文剑[1] 张宏家[1] Jia Songhao;Wang Maozhou;Han Jie;Jiang Wenjian;Zhang Hongjia(Department of Cardiac Surgery,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心脏外科,北京市心肺血管疾病研究所,100029

出　　处：《中华胸心血管外科杂志》2025年第3期163-167,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：国家重点研发计划(2021YFC2501104);国家自然科学基金(82170487,82241205);首都医科大学附属北京安贞医院重大科技创新研发专项(KCZD202203);首都医科大学附属北京安贞医院前沿技术预探索项目(KCQY202201)。

摘　　要：目的探索影响风湿性二尖瓣成形手术疗效的影响因素,从而筛选合适的患者接受风湿性二尖瓣成形手术。方法纳入从2016年1月到2022年3月间876例拟接受风湿性二尖瓣成形手术的患者,通过术前超声心动图和心脏CT多模态影像方法评估患者二尖瓣病变,将成功完成风湿性二尖瓣成形手术且无超过轻度的狭窄或反流定义为良好修复,通过单因素和多因素logistics回归分析影响风湿性二尖瓣成形手术疗效的影响因素。结果493例(56.2%)患者完成了效果良好的风湿性二尖瓣成形手术,体质量指数、纽约心功能分级、左心房直径、二尖瓣狭窄程度、二尖瓣反流程度、二尖瓣Agatston评分、乳头肌腱索融合是影响风湿性二尖瓣成形手术疗效的独立影响因素。结论在风湿性二尖瓣病变中约60%的患者可完成效果良好的二尖瓣成形手术,二尖瓣钙化程度是影响风湿性二尖瓣成形手术疗效的独立危险因素。ObjectiveTo explore the influencing factors on the outcome of rheumatic mitral valve repair,to screen suitable patients for rheumatic mitral valve repair.MethodsA total of 876 patients who planned to undergo rheumatic mitral valve repair between January 2016 and March 2022 were included in the study.Preoperative echocardiography and cardiac CT imaging were used to evaluate mitral valve disease in patients.Successful completion of rheumatic mitral valve repair without over mild stenosis or regurgitation was defined as satisfactory repair.Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors on the outcome of rheumatic mitral valve repair.Results493 patients(56.2%)completed satisfactory rheumatic mitral valve repair.BMI,NYHA classification,left atrial diameter,degree of mitral stenosis,degree of mitral regurgitation,Agatston score,and papillary tendon fusion were independent influencing factors on the outcome of rheumatic mitral valve repair.ConclusionNearly 60%of patients with rheumatic mitral valve disease could complete satisfactory rheumatic mitral valve repair,and the degree of mitral valve calcification was an independent risk factor affecting the outcome of rheumatic mitral valve repair.

关 键 词：风湿性二尖瓣病变 二尖瓣成形术 二尖瓣置换术 超声心动图 

分 类 号：R654.2[医药卫生—外科学]