摘要
目的应用经食管实时三维超声心动图(RT-3D-TEE)对风湿性二尖瓣关闭不全行置换术的患者进行二尖瓣对合参数的对比研究。方法风湿性二尖瓣关闭不全患者16例(风湿组;其中合并轻度狭窄者4例),其中男性6例,女性10例;年龄43~67岁,平均年龄53.4岁。正常对照组17例,其中男性7例,女性10例;年龄29~54岁,平均年龄43.1岁。分别行RT-3D-TEE检查并进行二尖瓣定量分析(MVQ)。结果风湿组在体二尖瓣对合面积为(160.69±50.44)mm^2,术后离体瓣膜的对合面积为(163.97±59.58)mm^2;对照组MVQ在体二尖瓣对合面积为(296.30±37.31)mm^2。两组在体二尖瓣对合面积差异有显著统计学意义(t=8.82,P=0.000 00)。MVQ所测二尖瓣对合面积与离体对合面积具有良好的相关性(r=0.892,P〈0.01)。Altman-Bland绘图分析结果表明,二者具有较好的一致性,两者的差值为-1.73±8.28,95%的置信区间为(-18.04,14.46)。风湿组左心室舒张早期及收缩末期瓣膜面积均较对照组增大(P〈0.05),对合面积及对合指数减小(P〈0.01)。结论 RT-3D-TEE可以实时检测二尖瓣的立体结构,MVQ所测二尖瓣对合参数可以较好地反映二尖瓣的实际对合程度,为二尖瓣病变手术方案的制定及术后疗效的预测提供理论依据。
Objective To compare the mitral valve involution parameters in patients before and after mitral valve replacement by rheumatic mitral insufficiency using real-time three-dimensional transesophageal echocardiography(RT-3D-TEE). Methods A total of 16 patients with rheumatic mitral insufficiency(rheumatic group, and 4 cases combined mild stenosis) were enrolled, which included 6 males and 10 females, aged 43- 67 years old with mean age of 53.4. The 17 healthy subjects was set as control group,included 7 males and 10 females, aged 29- 54 years old with mean age of 43.1. The correlation parameters of mitral leaflets and annulars were obtained by mitral valve quantitative(MVQ) procedure after examination of RT-3D-TEE, and the parameters were performed by statistical analysis. Results In rheumatic group, the mitral valve involution area in vivo was(160.69 ± 50.44) mm^2,and postoperative isolated valve involution area in vitro was(163.97 ± 59.58) mm^2; The mitral valve involution area in vivo was(296.30 ± 37.31) mm^2 in control group, and the mitral valve involution areas in vivo between 2 groups existed significant difference(t = 8.82, P = 0.000 00). The involution index measured by MVQ software had good correlation with the actual involution condition of mitral valve(r = 0.892, P〈0.01). The Altman-Bland analysis was good consistency between them, the difference value was- 1.73 ± 8.28 and 95 % confidence interval was(- 18.04, 14.46). The areas of left ventricular early diastolic and systolic valvular in rheumatism group were bigger than those in control group(P〈0.05), but the involution area and involution index decreased obviously(P〈0.01). Conclusion It is demonstrated that the three-dimensional structure of mitral valve could be observed real-time by RT-3D-TEE, the mitral valve involution parameters measured by MVQ software could show the actual condition of mitral valve, and provide theoretical basis for operation scheme and effect prediction.
出处
《生物医学工程与临床》
CAS
2014年第6期561-565,共5页
Biomedical Engineering and Clinical Medicine
关键词
二尖瓣置换术
风湿性病变
对合参数:经食管超声心动图
三维超声心动图
mitral valve replacement
rheumatic disease
involution parameters
transesophageal echocardiography
three-dimensional echocardiography