超声心动图评估不同程度二尖瓣反流患者二尖瓣环形态及心功能差异

摘要

目的 运用超声心动图比较不同程度二尖瓣反流患者二尖瓣环形态及心功能的差异.方法 对2012年10月至2013年8月78例不同程度二尖瓣反流患者行超声心动图检查.根据二尖瓣反流程度将患者分为轻度反流组(35例)、中度反流组(27例)和重度反流组(16例),比较3组患者超声心动图特点.结果 轻度、中度、重度二尖瓣反流3组间左心房内径、左心室舒张末期内径两两比较差异有统计学意义[(35 ± 6) mm比(42 ±6)mm比(47±8)mm、(47±10)mm比(51±7)mm比(58 ±6)mm],左心室收缩末期内径重度反流组与轻度、中度组比较差异有统计学意义[(39 ±6)mm比(33±9)、(36±7)mm,P＜0.05],3组间左心室射血分数差异无统计学意义(P＞0.05).重度反流组与轻、中度反流组间二尖瓣环面积相比,差异有统计学意义[(940±281) mm2比(642 ±276)、(685±247) mm2,P ＜0.05].中、重度反流组与轻度反流组瓣尖接合处相对于瓣环深度相比差异有统计学意义[(8.5±2.2)、(8.8±1.8)mm比(7.1 ±2.3)mm,P＜0.05].结论 不同二尖瓣反流程度患者二尖瓣环形态及心功能存在差异,行经皮二尖瓣修复术前可根据超声心动图检查结果指导手术方式的选择,重度二尖瓣反流患者可能行经皮二尖瓣环成形术获益更大.%Objective To assess the mitral valve morphological changes and cardiac function in different severities of mitral regurgitation.Methods Totally 78 patients with different severities of mitral regurgitation from October 2012 to August 2013 underwent echocardiography;they were divided into mild regurgitation group (35 cases),moderate regurgitation group (27 cases) and severe mitral regurgitation group (16 cases).The echocardiography parameters were compared among three groups.Results The left atrial diameter and left ventricular end diastolic diameter were statistically different between different groups [(35 ± 6) mm vs (42 ± 6) mm vs (47 ±8) mm,(47 ± 10) mm vs (51 ±7) mm vs (58 ±6) mm];the left ventricular end systolic diameter was significantly higher in severe mitral regurgitation group than that in mild and moderate regurgitation group [(39 ± 6) mm vs (33 ± 9),(36 ± 7) mm,P ＜ 0.05];the left ventricular ejection fraction had no significant differences among the three groups (P ＞ 0.05);the mitral annular area was significantly greater in severe mitral regurgitation group than that in mild and moderate regurgitation group [(940 ±281) mm2 vs (642 ±276),(685 ± 247) mm2,P ＜ 0.05];cusps junction depth relative to the annulus was significantly greater in moderate and severe regurgitation group than that in mild regurgitation group [(8.5 ± 2.2),(8.8 ± 1.8)mm vs (7.1 ± 2.3) mm,P ＜ 0.05].Conclusion The mitral valve ring morphology and cardiac function are different in different severities of mitral regurgitation;before percutaneous mitral valvuloplasty,echocardiography can guide the operation mode and patients with severe mitral regurgitation maybe benefit more from percutaneous mitral annuloplasty.