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主动脉瓣置换术后迟发性三尖瓣反流的危险因素分析

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目的 分析主动脉瓣置换术后迟发性三尖瓣反流的危险因素。方法 回顾性分析2016年1月至2017年12月因主动脉瓣病变在该院行主动脉瓣置换术的患者104例,收集患者围手术期资料并进行随访,三尖瓣出现中度及以上反流被定义有反流,轻度及以下反流定义为无反流。采用单因素分析和多因素logistic回归分析筛选发生迟发性三尖瓣反流的独立影响因素。结果 患者平均随访时间为(6。0±0。7)年,其中39例失访,5例死亡(1例因脑出血死亡、4例因心力衰竭死亡)。主动脉瓣术后迟发性三尖瓣反流的发生率为15。4%。单因素分析显示,心房颤动(70。0%vs。9。1%,P<0。001)及肺动脉压(x2=9。785,P=0。016)与三尖瓣反流有关;多因素logistic回归分析显示,心房颤动(OR=15。008,P=0。003)是主动脉瓣术后迟发性三尖瓣反流发生的独立危险因素。结论 对单纯行主动脉瓣手术的患者应关注心房颤动情况,以预防术后迟发性三尖瓣反流的发生。
Analysis of risk factors for delayed tricuspid regurgitation after aortic valve replacement
Objective To analyze the risk factors for delayed tricuspid regurgitation after aortic valve replacement.Methods A total of 104 cases of aortic valve replacements due to aortic valve lesion in this hos-pital from January 2016 to December 2017 were retrospectively analyzed.The perioperative data were collected and the follow up was performed.The appearance of moderate or more regurgitation in the tricuspid valve was defined as having regurgitation,and mild and below mild regurgitation was defined as no regurgitation.The in-dependent influencing factors for delayed tricuspid regurgitation were analyzed by using univariate and multi-variate logistic regression.Results The average follow-up period was (6.0±0.7)years.There were 39 cases lost the follow-up,5 cases died (1 case died of brain hemorrhage and 4 cases died of heart failure).The inci-dence rate of delayed tricuspid regurgitation after aortic valve operation was 15.4%.The univariate analysis showed that atrial fibrillation (70.0% vs. 9.1%,P<0.001) and pulmonary artery pressure (x2=9.785,P=0.016) were related with tricuspid regurgitation.The multivariate logistic regression analysis showed that at-rial fibrillation (OR=15.008,P=0.003) was the independent risk factor for the delayed tricuspid regurgita-tion after aortic valve surgery.Conclusion The patients with simple aortic valve surgery should pay attention to the atrial fibrillation situation to prevent the occurrence of delayed postoperative tricuspid regurgitation.

aortic valve replacementatrial fibrillationdelayed tricuspid regurgitationrisk factor

吴纯、许金国、张成鑫、葛圣林

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安徽医科大学第一附属医院心血管外科,合肥 230022

主动脉瓣置换术 心房颤动 迟发性三尖瓣反流 危险因素

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(16)