超声心动图在老年钙化性心脏瓣膜病诊断中的应用价值

Application value of echocardiography in the diagnosis of calcific valvular heart disease in the elderly

目的探讨超声心动图诊断老年钙化性心脏瓣膜病(SCVDH)的临床价值。方法选择2016年2月至2017年11月蓝田县中医医院收治的100例经临床诊断为SCVDH患者为观察组,并纳入同期30例健康志愿者为对照组,应用超声心动图检测两组受试者的心脏形态、功能、瓣膜钙化情况,并比较心脏功能指标的差异,分析SCVDH患者的超声心动图特征。结果观察组患者出现主动脉瓣膜钙化(65%)和二尖瓣钙化(55%),20%的患者合并主动脉瓣和二尖瓣钙化,瓣膜钙化超声心动图表现为瓣膜、瓣环以及边缘区回声增强,严重者可波及瓣膜尖部引起瓣膜狭窄或反流;观察组患者同时伴有心脏形态的改变,9%出现左心房扩大,12%左心室扩大,18%全心扩大,6%左心室心肌肥厚;观察组患者的左室舒张末内径(LVD)为(56.51±4.62) mm、左房内径(LAD)为(51.52±6.73) mm、左室射血分数(LVEF)为(49.05±4.18)%,对照组的LVD为(43.62±3.51) mm、LAD为(31.82±3.56) mm、LVEF为(69.85±10.95)%,组间比较差异均有显著统计学意义(P<0.01)。结论超声心动图可有效检出SCVDH患者钙化的瓣膜以及心脏形态和功能的病理改变,对诊断有重要价值。

Objective To explore the value of echocardiography in the diagnosis of calcified valvular heart disease （SCVDH） in the elderly. Methods One hundred CVDH patients in Lantian County Hospital of Traditional Chinese Medicine from February 2016 to November 2017 were selected as the study group, and 30 patients in the same period were taken as the control group. Echocardiography was used to detect the heart shape, function and valve calcification of the subjects, and the differences of cardiac function indexes were compared. The characteristics of echocardiography were analyzed. Results Aortic valve calcification （65%） and mitral calcification （55%） were found in the SCVDH patients. Aortic valve calcification combined with mitral valve calcification was found in 20% patients. Valve calcification echocardiography showed an enhanced echo in valve, valve ring and marginal areas, and severe cases may involve the apex of the valve and cause stenosis or regurgitation. In the study group, SCVDH patients were accompanied by heart morphological changes, including left atrial enlargement （9%）, left ventricular enlargement （12%）, cardiac enlargement （18%） and left ventricular hypertrophy （6%）. In the observation group, LVD, LAD, LVEF were （56.51±4.62） mm, （51.52±6.73） mm, （49.05±4.18）%, respectively, versus （43.62±3.51） mm, （31.82±3.56） mm, （69.85±10.95）% in the control group （P〈0.01）. Conclusion Echocardiography can effectively detect calcified valves and pathological changes of cardiac morphology and function in patients with SCVDH, which is of great value in the diagnosis of SCVDH.