经皮球囊二尖瓣扩张术后再狭窄及远期疗效

Restenosis and long term outcome after percutaneous balloon mitral valvuloplasty

目的对经皮二尖瓣球囊扩张术（ＰＢＭＶ）后病人长期随访资料作了回顾性分析，以确定再狭窄率、远期疗效及其影响因素。方法对１９８６年５月～１９９５年１２月随访资料完整的１６０例患者进行了回顾性研究，其中男５５例，女１０５例，年龄３８９±８９岁。随访时间１２～８１个月，平均３６±１５个月。对影响远期疗效的因素，用Ｃｏｘ风险模型作了分析。结果随访期间，１２７例（７９％）心功能持续改善。超声心动图测得的术前、术后及随访的二尖瓣口面积分别为１１５±０２ｃｍ２、２１５±０４ｃｍ２和１９２±０４ｃｍ２。２６例（１７％）发生再狭窄，其中１７例症状复发。结论ＰＢＭＶ术后可保持较好的远期疗效，平均３６个月的再狭窄率为１７％。术前超声心动图计分、心功能、有无心房颤动和左房压为长期疗效的独立预测因素。

Objective This study reports the clinical follow up of 160 patients who underwent percutaneous balloon mitral valvuloplasty (PBMV), in order to identify the long term outcome, the incidence of restenosis, and the determining factors of restenosis. Materials and Methods Eight hundred and thirty one patients with mitral stenosis (MS) underwent PBMV successfully from 1986 through 1995. Among the 831 patients, a retrospective study of 160 cases with complete date was presented in this article. This series included 105 females and 55 males. The mean age was 38.9±8.9 years (15 68 years). They were followed up after the procedure. The data were analyzed with SAS software. Results Follow up of 12 81 months (median 36±15 months )showed a symptomatic improvement rate of 79% (127 patients) with mitral valve area of 1.92±0.40 cm 2. Restenosis was demonstrated in 26 patients (17%).Conclusion PBMV as a treatment for appropriate patients with mitral stenosis has good long term results.