中国优秀运动员心脏瓣膜生理性返流调查分析

The Prevalence of Physiological Valvular Regurgitation in Chinese Elite Athletes

目的:了解中国优秀运动员心脏瓣膜生理性返流的发生情况。方法:自2000年对10个项目398名国家队运动员进行超声心动图检查,观察瓣膜运动及血流情况,测量心脏结构指标并计算其心功能指标。结果:398名运动员中,共检出各种瓣膜生理性返流90例(22.61%),其中男运动员44例(25.58%),女运动员46例(20.35%)。以三尖瓣返流最常见,检出率为14.07%,二尖瓣返流为4.52%,肺动脉瓣返流为1.76%,未检出主动脉瓣返流。联合瓣膜返流9例(2.26%),其中二尖瓣和三尖瓣联合返流6例,三尖瓣和肺动脉瓣联合返流3例。羽毛球项目心脏瓣膜生理性返流检出率最高,其次为游泳、女子垒球、举重和乒乓球,竞走运动员检出率为0。在兼具力量性和耐力性运动特点的混合型项目运动员中,与无返流者相比,检出返流者的左室舒张末期和收缩末期的内径增加、容积增大,右室和右房横径增加,射血分数下降但仍正常,其余结构和功能指标均无显著性差异。举重运动员中检出者和未检出者未见上述心脏结构和功能指标的差异。结论:中国优秀运动员瓣膜生理性返流检出率较高,以三尖瓣返流为主,性别之间无显著性差异,项目特点不明显。

Objective To investigate the prevalence of physiological valvular regurgitation in Chinese elite athletes. Methods Three hundred and ninety eight elite athletes from various China National Teams underwent echocardiographic examination. Results Of the 398 athletes, 90 were diagnosed as having physiological valvular regurgitation （22.61% ）, including 44 males and 46 females, mostly occurred in athletes involved badminton, and followed by swimming, softball, weightlifting and table tennis. The occurrence of tricuspid, mitral, pulmonary and aortic valvular, and combined valvular regurgitations were 14.07%, 4.52%, 1.76%, 0% and 2.26%, respectively. In athletes with regurgitation and involved in both endurance and strength training, the values of LVEDD, LVESD, LVEDV, LVESV, RVD, and RAD were significantly higher and EF was lower （but within the normal range） as compared with that in athletes without regurgitation. In weightlifters with or without regurgitation, changes mentioned above were not observed. Conclusion The detection rate of physiological valvular re- gurgitation in national level athletes is relatively high （22.62%） in this study. There was no gender difference and significant sport - specific characteristics in relation to physiological valvular regurgitation. Physiological tricuspid regurgitation is most commonly seen, followed by mitral and pulmonary valve regurgitation.