尿毒症性心瓣膜钙化特点及其对心脏结构和功能的影响

Character of cardiac valvular calcification in uremia patients and its influence on cardiac structure and function

目的 :应用超声心动图检测技术评价尿毒症性心瓣膜钙化的特点及其对心脏结构和功能的影响。方法 :从 32 6例尿毒症患者中选出 35例 5 0岁以下有二尖瓣和主动脉瓣钙化者作为钙化组 ,并选出 33例年龄、左心室舒张末期内经 (L VEDD)、左心房内经 (L AD)、主动脉内径 (AOD)、左心室壁厚度 (L VWT)、左心室射血分数 (L VEF)和血压基本与钙化组匹配的无瓣膜钙化的尿毒症患者作对照。观察指标为钙化的分布、反流量、L VEDD、L AD、AOD、L VWT和 L VEF,观察期为 1年。结果 :钙化特点为 :(1)主动脉瓣受累多见于二尖瓣 ;(2 )瓣环多于瓣叶 ;(3)主动脉无冠瓣环钙化多于左和右冠瓣环钙化 ;(4)二尖瓣后瓣环钙化多于前瓣环钙化。1年后 ,钙化组的反流程度明显重于对照组。两组受试者 L VEDD、AOD、L VET和 L VEF与 1年前相比无明显变化 ,但钙化组的 L AD较前明显扩大 ,而对照组无明显变化。 结论 :尿毒症瓣膜钙化会导致瓣膜口反流增加和L AD扩大。

Objective:To evaluate the character of cardiac valvular calcification in uremia patients and its effect on cardiac structure and function.Methods:Thirty five cases with mitral and aortic valve calcification were selected from 326 uremia patients.Control group consisted of 33 uremia patients without valvular calcification.Their age,LVEDD,LAD,AOD,LVWT,LVEF and blood pressure matched with calcification group.The observing indexs included distribution of calcification,degree of regurgitation,LVEDD,LAD,AOD,LVWT and LVEF.The observing duration was one year.Results:The results showed that characters of valvular calcification with uremia were similar to elder valvular calcification.The degree of regurgitation was more greater in calcification group than in control group after one year.The LAD was greater in calcification group after one year.Conclusion:Cardiac valvular calcification of uremia may cause the increase of regurgitation and enlarge LAD. [