彩色多普勒超声图指导风湿性心脏病二尖瓣狭窄球囊扩张术91例  

Color Doppler echocardiography in 91 patients with rheumatic mitral stenosis treated by PBMV

作　　者：陈伟[1] 许晓华[1] 李泉水[2] 李沿江[2] 王卫东[1] 廖涛[1] 孙雁[1] 

机构地区：[1]武警江西总队医院特诊科,江西南昌330001 [2]江西医学院第二医院超声科,江西南昌330006

出　　处：《第四军医大学学报》2003年第13期1240-1242,共3页Journal of the Fourth Military Medical University

摘　　要：目的 :应用彩色多普勒超声心动图指导经皮二尖瓣球囊成形术 (PBMV)治疗风湿性二尖瓣狭窄的价值 .方法 :运用彩超对行PBMV的患者进行术前术后检查 ,观察二尖瓣钙化程度及部位、开口形状、瓣口面积、二尖瓣返流 (MR)程度、瓣下病变、左房左室大小、左房有无血栓 .结果 :91例PB MV术后患者中 ,术后MR者 72例 ,其中MR新出现者 19例 ,MR加重者 8例 .与术前对比 ,术后二尖瓣开放幅度、二尖瓣口面积、二尖瓣跨瓣压、二尖瓣压差半降时间较术前有明显改善趋势 ,左房内径、肺动脉内径较术前有缩小趋势 .同时 ,术后左房压、右室压及肺动脉压也有下降趋势 .结论 :彩超能明确PBMV治疗二尖瓣狭窄的效果 .影响PBMV效果的因素较多 ,但二尖瓣钙化的程度、部位和瓣膜形态较为重要 .AIM: To evaluate the color Doppler echocardiography in percutaneous balloon mitral valvuloplasty (PBMV) in patients with rheumatic mitral stenosis. METHODS: The site and degree of mitral calcification, the mitral area, MR, subvalvular apparatus lesion, left atrium diameter and left ventricular diameter, left atrium thrombus were respectively observed with echocardiography before and after PBMV in 91 patients with rheumatic mitral stenosis. RESULTS : Compared with the data before PBMV in 91 cases, after PBMV there were 72 cases with MR, among whom 19 were new cases and 8 cases became more severe MR. There was obvious amelioration after the PBMV such as mitral area, mitral pressure gradient, mitral pressure half time, left atrium diameter and pulmonary diameter ( P < 0.01 ). There was obvious descend of left atrium pressure, right ventricular pressure and pulmonary pressure ( P < 0.01 ). CONCLUSION: Echocardiography can be used to assess the effects of PBMV in patients with rheumatic mitral stenosis. Calcification degree, sites of valve and mitral deformation are important factors of mitral regurgitation (MR) after PBMV in patients with rheumatic mitral stenosis.

关 键 词：二尖瓣球囊扩张术 彩色多普勒超声心动图 风湿性心脏病 二尖瓣狭窄 二尖瓣钙化 二尖瓣返流 

分 类 号：R542.5[医药卫生—心血管疾病]