自膨式主动脉瓣对主动脉瓣狭窄合并二叶式主动脉瓣患者疗效以及心功能的影响  

Effect of self-expanding aortic valve on curative effect and cardiac function in patients with AS complicated with BAV

作　　者：王磊[1] 卢甲 张雪亚[1] WANG Lei;LU Jia;ZHANG Xue-ya(Department of Cardiology,Henan Chest Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省胸科医院心血管内科,郑州450000

出　　处：《医药论坛杂志》2025年第5期529-534,共6页Journal of Medical Forum

基　　金：河南省医学科技攻关联合共建项目(LHGJ20220838)。

摘　　要：目的探讨自膨式主动脉瓣对主动脉瓣狭窄(aortic stenosis,AS)合并二叶式主动脉瓣(bileaflet aortic valve,BAV)患者疗效以及心功能的影响。方法选择2022年1月—2023年12月期间河南省胸科医院共招募100例AS合并BAV病患作为观察对象,使用随机数字表法将其分为对照组(外科主动脉瓣置换术,n=50)和观察组(经导管植入自膨式主动脉瓣膜治疗,n=50),观察两组治疗效果,并对两组术前术后的心功能指标、血清炎性因子、氧化应激指标及主动脉相关指标进行比较,并记录术后并发症发生情况。结果观察组术后1个月的左心室内径[(3.95±0.57)cm vs(4.36±0.48)cm]、室间隔厚度[(31.86±3.54)mmHg vs(35.26±3.71)mmHg]、肺动脉收缩压[(7.43±2.25)mm vs(9.17±2.54)mm]、e’值[(8.04±0.61)cm/s vs(9.83±0.75)cm/s]、血清单核细胞趋化蛋白1[(7.17±1.06)pg/L vs(9.51±1.38)pg/L]、五聚蛋白3[(1.09±0.23)pg/L vs(1.58±0.21)pg/L]和I细胞间黏附分子1水平[(212.53±38.41)pg/L vs(260.39±42.05)pg/L]、血清丙二醛[(6.25±1.14)μmol/L vs(8.41±1.03)μmol/L]水平均较对照组偏低(均P<0.05);其临床疗效[96.00%vs 82.00%]、血清超氧化物歧化酶水平[(81.04±10.58)ku/L vs(75.21±10.07)ku/L]及主动脉瓣跨瓣峰值压差[(214.25±41.37)cm/s vs(75.21±10.07)ku/L]、主动脉瓣流速[(24.58±13.65)mmHg vs(15.64±9.58)mmHg]和主动脉瓣瓣口面积[(1.56±0.84)mm^(2) vs(4.24±1.17)mm^(2)]均高于对照组(P均<0.05)。两组术后并发症发生率无明显差异(P>0.05)。结论采用自膨式主动脉瓣可有效提高AS合并BAV病患的临床疗效,改善其心功能和主动脉相关指标,减轻氧化应激和炎症反应,安全性较高。Objective To investigate the ffect of self-expanding aortic valve on the fficacy as well as cardiac function in patients with aortic stenosis(AS)combined with bileaflet aortic valve(BAV).Methods From January 2022 to De-cember 2023,a total of 100 patients with AS complicated with BAV admitted to the Henan Chest Hospital were reeruited as observation objects,and randomly divided into control group(surgical aortic valve replacement,n=50)and observation group(self-inflating aortic valve implantation via catheter,n=50)by ramdom number table method.The therapeutic effects of the two groups were observed,and the indexes of cardiae function,serum inflammatory factors and oxidative stress were compared before and after operation.Results The left ventricular intermal diameter[(3.95±0.57)cm Vs(4.36±0.48)cm],septal thickness[(31.86±3.54)mmHg vs(35.26±3.71)mmHg],pulmonary artery systolie pressure[(7.43±2.25)mmvs(9.17±2.54)mm],e'values[(8.04±0.61)cn/s vs(9.83±0.75)cm/s].serum monocyte chemotactie protein 1[(7.17±1.06)pg/L vs(9.51±1.38)pg/1].pentraxin 3[(1.09±0.23)pg/L vs(1.58±0.21)pg/L].and interelular adhesion molecule 1 levels[(212.53±38.41)pg/L.vs(260.39±42.05)pg/L],serum malondialdehyde[(6.25±1.14)μmol/L vs(8.41±1.03)μmol/L]levels were lower than those in the control group(all P<0.05);their clinical fficacy[96.00%vs 8200%],serum superoxide dismutase level[(81.04±10.58)ku/L vs(75.21±10.07)ku/L],peak pressure difference across the aortie valve[(214.25±41.37)cm/svs(75.21±10.07)ku/L],aortic valve flow rate[(24.58±13.65)mmHg vs(15.64±9.58)mmHg],aortic valve flow rate[(24.58±13.65)mmHg vs(15.64±9.58)mmHg],and aortic valve orifice area[(1.56±0.84)mm^(2)vs(4.24±1.17)mm^(2)]were higher than those in the control group(all P<0.05).There was no significant dfference in the inei-dence of postoperative complications between the two groups(P>0.05).Conclusion The use of self-expanding aortic valve can effectively improve the clinical outcomes of patients with AS combined with BAV,improve their cardiac function

关 键 词：自膨式主动脉瓣 主动脉瓣狭窄合并二叶式主动脉瓣 疗效分析 心功能 

分 类 号：R654.2[医药卫生—外科学]