摘要
目的:分析二尖瓣反流(mitral regurgitation,MR)患者患病率以及心脏彩超特点.方法:本研究为大样本单中心回顾性研究,连续入选2012年1月-2022年12月在新疆医科大学第一附属医院首次就诊行超声心动图的患者资料.基于心脏彩超结果,对MR患者资料进行分析,总结和归纳MR患病情况以及心脏彩超相关指标.结果:共纳入32个民族150 190例患者,MR患者的平均年龄为(61.90±15.05)岁,男女之比为1∶1.5.共检出MR患者31 495例,检出率为20.97％,在MR患者中,轻度(1+)、中度(2+)、中-重度(3+)、重度(4+)的患病率分别为13.73％、2.9％、0.46％、0.56％,随着年龄的增长患病率有增高趋势.1+MR中女性在各个年龄组的患病率均高于男性(P＜0.001).不同民族间,维吾尔族3+以上反流占比最大,汉族占比最低.无论是退行性MR(DMR)还是功能性MR(FMR),左心房内径(LAD)、左心室舒张末期内径(LVDD)、左心室收缩末期内径(LVSD)、左室射血分数(LVEF)都与MR相关联(均P＜0.001),其中随着LVEF减小及LVSD、LAD增大,3+以上MR的占比升高.1 501例3+及以上的MR患者中,531例(35.38％)患者为FMR,合并风湿性心脏病为227例(15.12％),合并感染性心内膜炎为33例(2.20％),合并瓣膜退行性病变为599例(39.91％).结论:MR发病率较高,是常见的心脏瓣膜疾病.男性与女性患病率存在差异.不同民族也有不同的发病特点.随着LVEF减小及LVSD增大,患者更易出现3+及以上MR.合并心脏原发疾病及瓣膜退行性病变的患者更易演变为重度MR.
Abstract
Objective:To summarize and analyze the prevalence of single-center large-sample mitral regurgita-tion(MR)patients and the characteristics of cardiac ultrasound.Methods:This study was a large-sample,single-center retrospective study,and the data of patients who underwent echocardiography for the first time in the First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2022 were continuously en-rolled.Based on the results of cardiac ultrasound,the data of MR patients were analyzed,and the prevalence of MR and the related indexes of cardiac ultrasound were summarized.Results:A total of 150,190 patients from 32 ethnic groups were enrolled,and the average age of MR patients was(61.90±15.05)years,and the male-to-fe-male ratio was 1∶1.5.A total of 31,495 MR patients were detected,with a detection rate of 20.97％,and the prevalence of mild(1+),moderate(2+),moderate-severe(3+)and severe(4+)were 13.73％,2.9％,0.46％and 0.56％,respectively,and the prevalence increased with age.The prevalence of 1+MR was higher in females than males in all age groups(P＜0.001).Among different ethnic groups,the proportion of Uyghur regurgitation above 3+is the largest,and the proportion of Han nationality is the lowest.Whether for degenerative MR(DMR)or functional MR(FMR),left atrial anterior-posterior diameter(LAD),left ventricular end-diastolic diameter(LVDD),left ventricular end-systolic diameter(LVSD)and left ventricular ejection fraction(LVEF)were all cor-related with the severity of MR(all P＜0.001),in which the proportion of MR above 3+increased with the de-crease of LVEF and the increase of LVSD and LAD.Among the 1 501 MR patients with 3+or above,531(35.38％)had FMR,227(15.12％)had rheumatic heart disease,33(2.20％)had infective endocarditis,and 599(39.91％)had valvular degeneration.Conclusion:MR has a high incidence and is a common heart valve disease.There is a difference in prevalence between males and females.Different ethnic groups also have different patho-genesis,which may be due to differences in genetic polymorphisms and pathogenic factors.With the decrease of LVEF and the increase of LVSD,patients are more likely to develop MR of 3+and above.Patients with primary cardiac disease and valve degeneration are more likely to develop severe MR.
基金项目
新疆维吾尔自治区科技支疆项目(2022E02057)
NETL
NSTL
万方数据