老年退行性心脏瓣膜病超声心动图分析

Analysis of the echocardiogram of senile degenerative heart valvular disease in elderly patients

目的分析老年退行性心脏瓣膜病(SDHVD)的超声心动图特征及相关病因。方法收集240例老年住院患者临床资料,根据超声心动图检查有无SDHVD分为对照组122例及SDHVD组118例,观察SDHVD组的心脏结构及心功能变化,分析其相关病因。结果 SDHVD组高血压、高胆固醇血症、动脉硬化检出率均高于对照组(P<0.01),主动脉硬化、左室松弛性降低检出率高于对照组(P<0.05);瓣膜病变部位以单纯主动脉瓣最多(54.2%),其次为二尖瓣和主动脉瓣联合病变(33.1%);瓣膜功能障碍中主动脉瓣关闭不全检出率最高。结论老年患者SDHVD主要发生于主动脉瓣;高血压、动脉硬化、冠心病的合并存在,是导致或加重老年人瓣膜退行性变的重要原因,年龄、高血压、高胆固醇血症是SDHVD发病的危险因素。

Objective To analyze the features of the echocardiogram of senile degenerative heart valvular disease （SDHVD） in elderly patients and the related causes. Methods The clinical data of 240 elderly patients were collected. According to the echocardiogram, the patients were divided into 2 groups, control group （patients without SDHVD, n=122） and SDHVD group （patients with SDHVD, n=118）. The heart structure and heart function were observed, and the related causes of SDHVD were analyzed. Results The detection rates of hypertension, hypercholesterolemia and arteriosclerosis in SDHVD group were higher than those in control group（P0.01）,and the detection rates of aortosclerosis, reduced left room relaxation were higher than those in control group（P0.05）;The main valve pathological changes were pure aorta petal diseases （54.2%）, followed by combined diseases of bicuspid valve and aorta petal （33.1%）. Of the valve function barrier, the aortic insufficiency was most frequent. Conclusions The degenerative heart valvular disease in elderly mainly occurs in the aorta petal. The concurrence of hypertension, arteriosclerosis and coronary disease is the main cause of SDHVD. Age, hypertension and hypercholesterolemia are risk factors of SDHVD.