二尖瓣几何结构与左室乳头肌功能不全二尖瓣反流机制的相关性

发布时间：2018-05-14 13:28

本文选题：二尖瓣闭锁不全 + 几何结构　；参考：《中国老年学杂志》2016年18期

【摘要】：目的利用超声心动图技术探讨二尖瓣几何结构与左室乳头肌功能不全二尖瓣反流机制的相关性。方法选取冠心病陈旧性下后壁心肌梗死合并乳头肌功能不全的患者和健康志愿者共92例,分为正常对照组38例(A组),冠心病合并乳头肌功能不全组54例(B组),二尖瓣外科成形术后组26例(C组,随机选自B组患者)。采用超声心动图测量二尖瓣前叶、后叶与二尖瓣环之间的几何角度,彩色多普勒血流成像系统评估二尖瓣反流程度,计算得到二尖瓣有效反流口面积,分析其相关性。结果 B组患者二尖瓣前后叶与二尖瓣环之间的角度较A组、C组患者明显增大(P0.01),且二尖瓣前后叶与二尖瓣环之间的角度与反流程度呈正相关;C组患者二尖瓣反流量明显低于B组患者(P0.01),与A组患者之间无统计学差异(P0.05)。结论冠心病引发左室乳头肌功能不全合并二尖瓣反流程度与二尖瓣前后叶及环间的几何角度密切相关;二尖瓣外科修补术可通过改善二尖瓣几何结构减轻反流程度。
[Abstract]:Objective to investigate the correlation between mitral valve geometry and mitral regurgitation mechanism of left ventricular papillary muscle insufficiency by echocardiography. Methods 92 patients with chronic inferior posterior wall myocardial infarction complicated with papillary muscle insufficiency and healthy volunteers were selected. They were divided into normal control group (n = 38), coronary heart disease with papillary muscle insufficiency group (n = 54), group B (n = 54) and group C (n = 26) after mitral valvuloplasty. The geometric angles between anterior, posterior and mitral annulus were measured by echocardiography. The degree of mitral regurgitation was evaluated by color Doppler flow imaging system. The effective mitral regurgitation area was calculated and its correlation was analyzed. Results the angle between anterior and posterior mitral valve and mitral annulus in group B was significantly larger than that in group A and C, and the angle between anterior and posterior lobe of mitral valve and mitral annulus was positively correlated with the degree of mitral regurgitation in group C. The quantity of P0.01 was significantly lower than that of group B, and there was no significant difference between group A and group A (P 0.05). Conclusion the degree of mitral regurgitation caused by left ventricular papillary muscle insufficiency caused by coronary heart disease is closely related to the geometric angle between the anterior and posterior lobe and annulus of the mitral valve, and mitral valve repair can reduce the degree of regurgitation by improving the geometric structure of the mitral valve.
【作者单位】：郑州大学第二附属医院超声科;
【基金】：河南省医学科技攻关计划项目(201003129)
【分类号】：R542.51;R540.45

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