超声心动图对风湿性二尖瓣狭窄经球囊扩张术远期疗效评价

Evaluation long-term results of PBMV treatment on MS patients by Echocardiography

目的探讨运用经胸超声心动图(TTE)评价风湿性二尖瓣狭窄患者(MS)经皮二尖瓣球囊扩张术(PBMV)的远期疗效。方法对1995年5月至2011年10月随访资料完整的86例经皮二尖瓣球囊扩张术后病例进行回顾性研究,随访时间6年至17年。测量术前、术后二尖瓣口面积(MVA)、二尖瓣平均跨瓣压差(MV△P)、左房内径(LAD)、射血分数(EF)、左室舒张末内径(LVDd)、肺动脉收缩压(PAPS)、二尖瓣、三尖瓣返流量。结果术后6年以上的患者MVA、MV△P、LAD、EF、LVDd、PAPS均较术前有明显改善(P<0.01),术后三尖瓣返流量较术前明显减少(P<0.01),二尖瓣返流量无明显变化(P>0.05),其中21例发生再狭窄,再狭窄率24.62%。结论 MS经PBMV治疗术后6年以上远期疗效良好,TTE对PBMV术后远期疗效能提供客观准确的评价。

Objective To evaluate the long-term results by transthoracic echocardiography after percutaneous ballon mitral valvuloplasty(PBMV) in patients with mitral stenosis(MS).Methods A retrospective study was performed on 86 patients treated with PBMV from May 1995 to October 2011,and the data of these patients were integrated.The follow-up time from 6 years to 17 years.MVA,MV△P,LAD,EF,LVDd,PAPS,Mitral and Tricuspid valve back flow rate were measured on these patients.Results In addition to a significant improvement in mitral valve area(MVA),trans-mitral valve pressure(MV△P),left artial diameter(LAD),ejection fraction(EF),end diastolic diameter of left ventricle(LVDd) and pulmonary artery systolic(PAPS)(all P&lt;0.01),a significant decrease in tricuspid valve back flow rate(P&lt;0.01) and no significant change in mitral valve back flow rate(P&gt;0.05) were observed in the patients after surgery for more than 6 years.Recurrence of MS happened on 21 cases and the recurrence rate was 24.62%. Conclusion Long-term efficacy of PBMV treatment on MS patients after more than 6 years is satisfactory.TTE can be an objective way to evaluate the long-term efficacy of PBMV treatment.