老年退行性主动脉瓣返流与左室舒张功能关系的探讨

THE CORRELATION BETWEEN CALCIFIC AORTIC REGURGITATION AND LEFT VENTRICOLAR DIASTOLIC FUNCTION IN THE SENILE PATIENTS

老年退行性瓣膜病主要累及主动脉瓣，且钙化性主动脉瓣返流（ＣＡＲ）明显多于主动脉瓣狭窄（ＣＡＳ）．本文对３０例ＣＡＲ及３０例无ＣＡＲ者用超声心动图（ＵＣＧ）分别测量左房内径（ＬＡＤ）、左室心肌重量指数（ＬＶＭＩ）、左室射血分数（ＬＶＥＦ），并用脉冲式多普勒超声测量二尖瓣峰值血流速度比值（Ａ／Ｅ）。经ｔ检验及相关分析显示：ＣＡＲ对左室舒张功能（ＬＶＤＦ）确有影响，且发生在对左室收缩功能（ＬＶＳＦ）影响之前。此外，判断老年人ＬＶＤＰ指标Ａ／Ｅ应以Ａ／Ｅ大于２为标准；ＣＡＲ与ＬＶＭＩ及ＬＡＤ呈正相关；ＬＢＭＩ与ＬＶＥＰ呈负相关。提示ＬＶＭＩ既影响ＬＶＤＦ也影响ＬＶＳＦ。总之，ＣＡＲ应受到足够的重视，而且，在考虑对心脏功能影响时，ＬＶＤＦ比ＬＶＳＦ更应受到重视；这样有宜于临床治疗及预后。

The calcific valvular disease is the most common disease in the elderly with valvular disorder,of which the aortic valve is frequently affected.And clinically,the patients with calcific aortic regurgitation(CAR)are much more than those with degenerative aortic stensis,In this study,60 patients over the age of 60were investigated by 2-D and pulsed Doppler echocardiography.30 of them with CAR as the investigatinggroup were compared with the control of 30 subjects without CAR in the aspects of LAD, LVMI and LVDF,The result shows that CAR correlats closely with LVMI,LAD and LVDF,and the LVMI affects not only theleft ventricular systolic function(LVSF) but also the left ventricular diastolic function(LVDF).Thus weshould pay more attention to the LVDF Whch is inattentively affected by CAR in the elderly.