摘要
目的探讨超声检查对老年退行性心脏瓣膜病与颈动脉粥样硬化关系的评价价值。方法选择2016年7月至2018年7月间佛山市第五人民医院诊治的150例退行性心脏瓣膜病患者纳入观察组,另选择30例健康志愿者为对照组,比较对照组与不同心脏瓣膜钙化程度分级患者心功能指标、颈动脉硬化情况的差异。根据有无心脏形态改变对观察组患者进行分组,比较两组患者颈动脉硬化情况。结果随着心脏瓣膜钙化分级的增加,观察组中1级、2级及3级患者左室舒张末内径(LVD)[(43.86±4.28) mm vs (50.35±5.86) mm vs (56.37±6.72) mm]、左房内径(LAD)[(33.24±4.83) mm vs (42.25±4.98) mm vs (49.68±5.37) mm]逐渐增大,左室射血分数(LVEF)[(69.28±9.25)%vs (60.32±7.65)%vs (51.98±6.25)%]逐渐降低,不同分级间两两比较差异均有统计学意义(P<0.05);2级及3级患者LVD、LAD及LVEF与对照组[(41.23±4.66) mm,(31.25±4.28) mm,(71.32±9.25) mm]比较差异均有统计学意义(P<0.05);随着心脏瓣膜钙化分级的增加,观察组1级、2级及3级患者颈动脉内膜厚度(IMT)逐渐增大[(1.09±0.36)mm vs (1.22±0.40) mm vs (1.28±0.43) mm],颈动脉斑块积分[(1.66±0.48)分vs (2.43±0.82)分vs (2.88±0.96分)]逐渐增高,不同分级间两两比较差异均有统计学意义(P<0.05);2级及3级患者IMT及颈动脉斑块积分与对照组[(1.06±0.33) mm,(1.62±0.50)分]比较差异均有统计学意义(P<0.05);与无心脏形态改变患者比较,存在心脏形态改变患者的IMT更大[(1.26±0.46) mm vs(1.19±0.32) mm],颈动脉斑块积分更高[(1.96±0.55)分vs (2.62±0.78)分],差异均有统计学意义(P<0.05)。结论超声检查能够准确评价老年退行性心脏瓣膜病及颈动脉粥样硬化的关系,随着老年退行性心脏瓣膜病病情的加重,患者颈动脉硬化程度也加重。
Objective To investigate the value of ultrasonography in evaluating the relationship between degenerative valvular heart disease and carotid atherosclerosis in the elderly. Methods From July 2016 to July 2018, 150 patients with degenerative valvular heart disease were selected as the observation group, and 30 healthy volunteers as the control group. The cardiac function and carotid atherosclerosis were compared between the two groups. Patients in the observation group were divided into two subgroups according to whether there were cardiac morphological changes, and carotid atherosclerosis was compared between the two groups. Results In the observation group, Left ventricular end-diastolic diameter(LVD), left atrial diameter(LAD) increased with the increase of cardiac valve calcification grading(grade 1 vs grade 2 vs grade 3): LVD(43.86±4.28) mm vs(50.35±5.86) mm vs(56.37±6.72) mm, LAD(33.24±4.83) mm vs(42.25 ± 4.98) mm vs(49.68 ± 5.37) mm;Left ventricular ejection fraction(LVEF) decreased gradually(P<0.05):(69.28±9.25)% vs(60.32±7.65)% vs(51.98±6.25)%. LVD, LAD and LVEF in grade 2 and grade 3 patients were significantly different from those in control group(P<0.05), which were(41.23±4.66) mm,(31.25±4.28) mm,(71.32±9.25) mm in the control group. With the increase of heart valve calcification grading, carotid intima thickness(IMT) increased gradually:(1.09±0.36) mm vs(1.22±0.40) mm vs(1.28±0.43) mm;and carotid plaque score increased gradually:(1.66±0.48) vs(2.43±0.82) vs(2.88±0.96);the difference was statistically significant(P<0.05). The IMT and carotid plaque scores of grade 2 and grade 3 patients were significantly different from those of the control group(P<0.05), which were(1.06±0.33) mm, 1.62±0.50. Compared with patients without cardiac morphological changes, patients with cardiac morphological changes had significantly higher IMT and significantly higher carotid plaque score(P<0.05): IMT(1.26±0.46) mm vs(1.19±0.32) mm, carotid plaque score(1.96±0.55) vs(2.62±0.78). Conclusion Ultrasonography can accurately evaluate the relationship between senile degenerative heart valvular disease and carotid atherosclerosis. With the severity of senile degenerative heart valvular disease, the degree of carotid atherosclerosis aggravated.
作者
郑斌
李丽芬
叶淑芬
ZHENG Bin;LI Li-fen;YE Shu-fen(Department of Functional Examination Section, Foshan Fifth People's Hospital, Foshan 528211,Guangdong,CHINA)
出处
《海南医学》
CAS
2019年第5期613-615,共3页
Hainan Medical Journal
关键词
超声
颈动脉
老年
退行性心脏瓣膜病
瓣膜
钙化
Ultrasound
Carotid artery
The elderly
Degenerative heart valvular disease
Valve
Calcification
