邵阳地区心脏瓣膜病发病率及病因调查

Investigation of the incidence and etiology of valvular heart disease in Shaoyang area

目的 调查分析邵阳地区心脏瓣膜病的发病率、病因及其演变。方法 对单一中心的1010名18～74岁人群在自填调查表的基础上普查心脏彩色超声心动图(心脏彩超)、心电图、心脏听诊等:结果 心脏瓣膜病总发病率为5.3％,男性发病率3.8％,女性6.9％(P>0.05)。各瓣膜病发病率:单纯主动脉瓣关闭不全2.5％,单纯二尖瓣关闭不全1.5％,单纯二尖瓣狭窄0.1％,单纯三尖瓣关闭不全0.1％,二尖瓣脱垂0.2％,多瓣膜病1.0％.未检出单纯主动脉瓣、三尖瓣狭窄者,亦未检出肺动脉瓣病变者。各年龄段发病率:18～29岁为1.5％,30～39岁为2.7％,40～49岁为1.8％,50～59岁为4.8％,60～74岁为13.2％。原发病:老年退行性瓣膜病占31.5％,高血压病、冠心病各占16.7％,高血压病合并冠心病(高冠心病)占1.9％,风心病占13.0％,扩张型心肌病和甲状腺功能亢进症(甲亢)各占3.7％,心肌炎、先心病各占1.9％,糖尿病(可能原因)占3.7％,另有5.6％原因不明。结论 邵阳地区心脏瓣膜病总发病率5.3％,男女发病无显著差异,其原发病已由风心病为主逐渐演变为老年退行性瓣膜病为主。

Objective To investigate the incidence and etiological evolution of valvular heart disease.Methods To analysis 1010 peoples from a single center and aged from 18 to 74（male 505, female 505 ）, the investigation list, color echocardiogram, electrocardiogram and heart auscultation were used. Results （1）The total incidence of valvular heart disease was 5.3 % in Shaoyang area, male 3.8 %, female 6.9% （P〉0.05）. （2）The incidence of pure aortic incompetence was 2.5%, pure mitral incompetence 1.5 %, pure mitral stenosis 0.1%, pure tricuspid incompetence 0.1%, mitral valve prolapse 0.2 %, multivalvular heart disease 1.0% . Aortic stenosis, tricuspid stenosis and pulmonary abnormal were not founded. （3）The distribution of ages in incidence was： 1.5% between 18 and 29, 2.7% between 30 and 39, 1.8% between 40 and 49, 4.8% between 50 and 59, 13.2% between 60 and 74. （4）The distribution of etiology： degenerative ealcific valvular disease in the elderly was 31.5 %, hypertension 16.7 %, coronary heart disease 16.7%, hypertension and coronary heart disease merger 1.9%, rheumatic heart disease 13.0 %, dilated cardiomyopathy 3.7 %, hyperthyroidism 3.7 %, myocarditis 1.9 %, congenital cardiovascular disease 1.9 %, diabetes mellitus （possible cause） 3.7 %, unknown cause 5.6 %. Conclusions The total incidence of valvular heart disease in Shaoyang area was 5.3 % . The capital etiology has been charged from rheumatic heart disease to degenerative calcific valvular disease in the elderly gradually.