超声心动图对主动脉瓣二瓣化患者升主动脉及颈动脉弹性的研究  

Evaluation of Aortic and Carotid Elasticity in Patients with Bicuspid Aortic Valve by Echocardiography

作　　者：李阳[1] 邓又斌[1] 杨好意[1] 毕小军[1] 张隽[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉市430030

出　　处：《中国超声医学杂志》2015年第8期705-708,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的采用超声心动图研究瓣膜功能正常的主动脉瓣二瓣化(BAV)患者升主动脉及颈动脉的弹性特征,探讨BAV相关的动脉病变的致病原因。方法采用M型超声心动图测量升主动脉和颈动脉收缩末、舒张末期内径,同时记录动脉血压,通过计算得出升主动脉和颈动脉的应变、扩张性和僵硬指数。比较两组间升主动脉和颈动脉的内径、应变、扩张性和僵硬指数的差异,并分析升主动脉应变、扩张性、僵硬指数与动脉内径、年龄的相关性。结果 BAV患者的升主动脉内径、僵硬指数均大于健康志愿者,应变、扩张性均小于健康志愿者,差异具有统计学意义(P<0.05);颈动脉内径、僵硬指数均大于健康志愿者,应变小于健康志愿者,差异具有统计学意义(P<0.05)。BAV组升主动脉应变、扩张性与年龄呈负相关(r=-0.397,P<0.05;r=-0.393,P<0.05),僵硬指数与年龄呈正相关(r=0.565,P<0.01);升主动脉应变、扩张性、僵硬指数与动脉内径没有显著相关性(P均>0.05)。结论 BAV患者升主动脉和颈动脉血管扩张、弹性下降;BAV相关的动脉病变不是完全由瓣膜引起的血液动力学状态变化而导致的,还与其他因素有关,需要进一步研究。Objective To investigate the pathogenesis of aortic and carotid arteries in patients with bicuspid aortic valve(BAV)without significant valvular impairment,the elasticity of aorta and carotid artery was evaluated by echocardiography.Methods Aortic and carotid end-diastolic diameters and end-systolic diameters were measured by M-mode echocardiography.Aortic strain,aortic distensibility(AoDIS)and aortic stiffness index(AoSI)were calculated.Carotid strain,carotid distensibility(CaDIS)and carotid stiffness index(CaSI)was acquired as well.The differences of vascular strain,distensibility and stiffness index of aorta and carotid artery between the patients and healthy controls were compared and the correlation between aortic strain,distensibility and stiffness index,and the age and vessel diameter in BAV patients were analyzed respectively.Results Compared with healthy controls,aortic strain,carotid strain and AoDIS significantly decreased(P<0.05),while aortic diameter,AoSI,carotid diameter and CaSI significantly increased in BAV patients(P<0.05).A certain correlation was found between aortic strain,distensibility and stiffness index and the age of BAV patients(r=-0.397,P<0.05;r=-0.393,P<0.05;r=0.565,P<0.01),but no correlation was observed between aortic strain,distensibility and stiffness index and aortic diameter in BAV patients(All P>0.05).Conclusions Aortic and carotid elasticity are impaired in BAV patients without significant valve dysfunction.BAV-associated aortopathy is not completely caused by secondary hemodynamic change,but also with other factors in need of further research.

关 键 词：超声心动描记术 主动脉瓣二瓣化畸形 弹性 主动脉 颈动脉 

分 类 号：R540.45[医药卫生—心血管疾病]