摘要
目的 应用经胸三维超声心动图定量评价房性及室性功能性二尖瓣反流患者二尖瓣构型,探讨其临床应用价值.方法 选取于我院心内科就诊的房性功能性二尖瓣反流患者53例(AFMR组)和室性功能性二尖瓣反流患者68例(VFMR组),另选同期年龄、性别与之匹配的50例健康体检者作为对照组,应用经胸三维超声心动图检测各组二尖瓣相关参数,包括瓣环前后径(AP)、瓣环前外-后内侧直径(ALPM)、AP与ALPM比值(AP/ALPM)、瓣环高度(AH)、瓣环周长(CD)、瓣环面积(AA)、瓣环非平面角度(NPA)、前小叶面积(ALA)、后小叶面积(PLA)、小叶总面积(TLA)、帐篷容积(VTent)、帐篷高度(HTent)、后小叶角度(PLθ)及TLA与AA比值(TLA/AA),比较各组上述参数的差异.结果 与对照组比较,AFMR组和VFMR组AP、ALPM、AH、CD、AA、NPA、ALA、PLA、TLA、PLθ均增大,TLA/AA减小,AFMR组VTent、HTent均减小,VFMR组VTent、HTent均增大,差异均有统计学意义(均P<0.05);与AFMR组比较,VFMR组AP、ALA、PLA、TLA、TLA/AA、VTent、HTent、AP/ALPM均增大,ALPM、PLθ均减少,差异均有统计学意义(均P<0.05).结论 经胸三维超声心动图可定量评价房性及室性功能性二尖瓣反流患者二尖瓣构型,为临床干预提供一定的参考依据.
Abstract
Objective To explore the clinical application value of transthoracic three-dimensional echocardiography in evaluating mitral valve configuration in patients with atrial and ventricular functional mitral regurgitation.Methods Fifty-three patients with atrial functional mitral regurgitation(AFMR group)and 68 patients with ventricular functional mitral regurgitation(VFMR group)were selected from the department of cardiology of our hospital,Additionally,50 cases of age and sex-matched healthy volunteers were included as the control group.Mitral valve parameters,including anterior-posterior diameter(AP),anterior leaflet-to-posterior leaflet diameter(ALPM),ratio of AP and ALPM(AP/ALPM),annular height(AH),annular circumference(CD),annular area(AA),non-planar angle(NPA),anterior leaflet area(ALA),posterior leaflet area(PLA),total leaflet area(TLA),tenting volume(VTent),tenting height(HTent),posterior leaflet angle(PLθ)and ratio of TLA and AA(TLA/AA)in each group were measured by transthoracic real-time three-dimensional echocardiography.The differences of above parameters among the groups were compared.Results Compared with the control group,AP,ALPM,AH,CD,AA,NPA,ALA,PLA,TLA and PLθ were increased,and TLA/AA was decreased in the AFMR group and the VFMR group,VTent and HTent were decreased in the AFMR group,VTent and HTent were increased in the VFMR group,and the differences were statistically significant(all P<0.05).Compared with the AFMR group,AP,ALA,PLA,TLA,TLA/AA,VTent,HTent and AP/ALPM were increased,ALPM and PLθ were decreased,and the differences were statistically significant(all P<0.05).Conclusion Transthoracic three-dimensional echocardiography can quantitatively assess the mitral valve configuration in patients with atrial and ventricular functional mitral regurgitation,providing valuable reference clinical intervention.
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