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中华诊断学电子杂志 ›› 2019, Vol. 07 ›› Issue (02) : 129 -133. doi: 10.3877/cma.j.issn.2095-655X.2019.02.012

所属专题: 文献

临床研究

超声心动图在二叶式主动脉瓣及其并发症诊治中的应用价值
赵睿1, 何逸尧1, 许宇辰1, 程蕾蕾,1   
  1. 1. 200032 上海,复旦大学附属中山医院心脏超声诊断科 上海市心血管病研究所 上海市影像医学研究所
  • 收稿日期:2018-11-11 出版日期:2019-05-26
  • 通信作者: 程蕾蕾

The application value of echocardiography in diagnosis and treatment of bicuspid aortic valve and its major complications

Rui Zhao1, Yiyao He1, Yuchen Xu1, Leilei Cheng,1   

  1. 1. Department of Echocardiography, Zhongshan Hospital Affiliated to Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Insitute of Medical Imaging, Shanghai 200032, China
  • Received:2018-11-11 Published:2019-05-26
  • Corresponding author: Leilei Cheng
  • About author:
    Corresponding author: Cheng Leilei, Email:
引用本文:

赵睿, 何逸尧, 许宇辰, 程蕾蕾. 超声心动图在二叶式主动脉瓣及其并发症诊治中的应用价值[J/OL]. 中华诊断学电子杂志, 2019, 07(02): 129-133.

Rui Zhao, Yiyao He, Yuchen Xu, Leilei Cheng. The application value of echocardiography in diagnosis and treatment of bicuspid aortic valve and its major complications[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2019, 07(02): 129-133.

目的

探讨超声心动图在二叶式主动脉瓣(BAV)及其相关并发症诊治中的应用价值。

方法

研究对象为2017年1月至10月于复旦大学附属中山医院心脏超声诊断科行超声心动图检查并诊断为BAV的患者,共120例,回顾性分析其超声及临床特点。选取孤立性主动脉瓣狭窄(AS)患者35例,依据美国心脏协会(AHA)/美国心脏病学会(ACC)标准,以平均跨瓣压差为标准分为轻度AS(<20 mmHg)(1 mmHg=0.133 kPa)6例,中度AS(20~39 mmHg)17例,和重度AS(≥40 mmHg)12例,并比较BAV合并轻中度AS患者与合并重度AS患者的临床及超声特征。

结果

120例BAV患者年龄为18~82岁,男性75例,平均年龄为(51.11±15.46)岁;女性45例,平均年龄为(55.84±13.81)岁,男女患者之间年龄差异无统计学意义(t=-1.69,P>0.05)。19例(15.8%)患者为单纯BAV而无相关并发症,101例(84.2%)患者均存在不同程度的并发症。35例(29.2%)并发AS,平均年龄为(60.17±13.54)岁,16例(13.3%)并发主动脉瓣反流(AR),平均年龄为(46.44±15.28)岁,并发AR者年龄小于并发AS者(t=-3.23,P<0.05)。30例患者(25.0%)并发升主动脉扩张,平均年龄(54.83±10.11)岁;另有20例患者(16.7%)同时合并1种及以上并发症。共有27例患者(22.5%)接受手术治疗;12例合并重度AS的患者中有9例接受手术治疗,其中1例为经导管主动脉瓣置换术(TAVI)。并发重度AS者室间隔厚度[(12.80±2.20)mm]及左室后壁厚度[(11.90±1.97)mm]较轻中度AS者增厚[(9.96±1.40)mm,(9.30±1.02)mm; t=-4.49,Z=-3.39,均P<0.05]。

结论

BAV合并各种并发症的患者比例高,合并严重并发症而需接受外科或心脏介入手术治疗的患者比例亦高,超声心动图对这部分患者有极大的监测价值。

Objective

To investigate the value of echocardiography in diagnosis and treatment of patients with bicuspid aortic valve (BAV).

Methods

Echocardiographic and clinical data of BAV patients who admitted to Zhongshan Hospital, Fudan University from January 2017 to October 2017 were collected. According to their echocardiographic mean pressure gradient , the patients with aortic stenosis (AS) were split into mild AS(n=6) , moderate AS(n=17) and severe AS(n=12). Echocardiographic and clinical data of the mild/moderate and severe patients were retrospectively analyzed.

Results

A total of 120 BAV patients were included, 75 males and 45 females. There was no significant difference in the age between males and females [(mean ages were (51.11±15.46) years and (55.84±13.81) years, respectively, t=-1.69, P>0.05]. Among them, only 19 patients (15.8%) were comfirmed as BAV without related complications, while 35 cases (29.2%) were identified with aortic stenosis (AS), 16 (13.3%) with aortic regurgitation (AR) and 20 (16.7%) with more than one complication. Patients with AR [mean age were (46.44±15.28)years] were younger than those with AS [mean age were (60.17±13.54) years] (t=-3.23, P<0.05). Seventy-five percent (9/12) of the patients with severe AS received operation including tranditional surgery (8 cases) and transcatheter aortic valve implantation (TAVI). The thickness of interventricular septum (IVS, 1 case) and left ventricular posterior wall (LVPW) in the study objects with severe AS [(12.80±2.20)mm, (11.90±1.97)mm] were thicker than those with mild or moderate AS [(9.96±1.40)mm, (9.30±1.02)mm](t=-4.49, Z=-3.39, all P<0.05).

Conclusions

The proportion of BAV patients with complications is high. Those with serious complications require surgical or cardiac interventional treatment. Echocardiography plays an important role in BAV monitoring.

表1 二叶式主动脉瓣并发主动脉瓣狭窄患者超声及临床特征比较(±s)
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