老年钙化性心脏瓣膜病的超声心动图表现

Echocardiographic characteristics of calcific valvular heart disease

目的应用超声心动图研究老年钙化性心脏瓣膜病（CVHD）的特点。方法接受经胸超声心动图检查的9017例50岁以上患者，以二维、M型、彩色多普勒血流图检测CVHD，记录各瓣膜情况，结果共检出CVHD574例，检出率随年龄增加而升高；性别之间无显著性差异；主动脉瓣钙化多于二尖瓣，无冠瓣钙化多于左、右冠瓣；主动脉瓣瓣尖及二尖瓣瓣环钙化检出率高；钙化形态以3-10mm斑状钙化最多见；部分患者出现血流动力学改变；该病常伴随于高血压病、冠心病、主动脉硬化等疾病。结论超声心动图可检出CVHD钙化部位、大小、瓣膜狭窄及关闭不全程度，为CVHD早期诊断提供影像学依据。

Objective To study the characteristics of ealcific valvular heart disease （CVHD） with the aid of echocardiography. Methods Nine thousand and seventeen patients over 50 year-old who had received transthoracic echocardiographic examination were enrolled in the study. Diagnosis of CVHD was made with 2 dimension, M-mode and color Doppler echocardiography. General state of health, clinical manifestation and history of CVHD patients were also analyzed. Results Five hundred and seventy-four cases of CVHD were diagnosed and the characteristics of CVHD were observed. The diagnostic rate increased as the age increased. There was no significant difference be- tween male and female. The calcified regions were commoner in aortic valves than in mitral valves, more frequent in non-coronary valves than in right or left coronary valves, and more frequently seen at tips of aortic valves and armuli of mitral valves than in other parts. The size of calcific plaques was usually between 3 and 10mm. Hemodynamic changes could be found in some patients. History of hypertension, coronary artery disease, and arteriosclerosis of the aorta were often found in these patients. Conclusions Echocardiography can be used to evaluate the position of calcification, size of calcification area, and degree of valvular stenosis or insufficiency, thus offers useful information for early diagnosis and treatment, and prognosis of CVHD in clinic.