摘要
目的分析重度主动脉瓣狭窄患者行瓣膜置换术后左室流出道(LVOT)流速变化特征。方法选取重度主动脉瓣狭窄行主动脉瓣置换术的患者114例,根据术后左室流出道流速变化情况分为流速增幅≥50%组(A组45例)和流速无明显增高组(B组69例),两组分别于术前3 d、术后7 d、3个月及6个月行超声心动图检查,测量左室舒张末期内径(LVEDD)、室间隔厚度及LVOT流速,并对其结果进行对比分析。术前判断主动脉瓣是否合并瓣叶畸形,术后记录人工瓣膜的性质,分析其对LVOT流速变化的影响。结果术前3 d、术后7 d及3个月两组LVEDD和室间隔厚度与LVEDD比值比较差异均有统计学意义(均P<0.05),术后6个月比较差异无统计学意义。两组术前主动脉瓣是否合并瓣叶畸形及术后人工瓣膜性质比较差异无统计学意义。结论 LVEDD较小、室间隔厚度与LVEDD比值较大时,主动脉瓣狭窄患者行瓣膜置换术后LVOT流速增快发生率高;LVOT流速变化呈先增加后降低的趋势,多于术后6个月恢复正常。
Objective To investigate the sonographic characteristics of left ventricular outflow tract（LVOT）velocity variation after valvular replacement in patients with severe aortic stenosis（AS）.Methods A total of 114 severe AS patients with aortic valve replacement（AVR）were selected and divided into two groups：group A,the velocity was increased by more than or equal to 50 %,group B,the velocity was increased less than 50%.Echocardiography was performed 3 d before operation,7 d,3 months and 6 months after operation. Left ventricular end-diastolic diameter（LVEDD）,ventricular septal thickness and LVOT velocity were measured and compared between the groups.The effects of combined valve deformity before operation and the property of artificial valves after operation on LVOT velocity were analyzed.Results The difference of LVEDD and the ratio of ventricular septal thickness and LVEDD between the two groups was statistically significant 3 d before operation,7 d,3 months after operation（all P〈0.05）.There was no significant difference 6 months after the operation.There was no significant difference between the two groups in whether combined with valve deformity and the property of artificial valves.Conclusion There is high incidence of the LVOT velocity increase in AS patients after AVR,which is more likely to occur in the patients with smaller LVEDD,higher ratio of ventricular septal thickness and LVEDD.The velocities first increase and then decrease after treatment,most of them return to normal after 6 months.
作者
张丽
徐振
姚莉萍
ZHANG Li XU Zhen YAO Liping(Department of Cardiothoraeic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University Medical School, Shanghai 200092, Chin)
出处
《临床超声医学杂志》
2017年第7期484-486,共3页
Journal of Clinical Ultrasound in Medicine
