• 医学文献
  • 知识库
  • 评价分析
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
热搜词:
换一批
论文 期刊
取消
高级检索

检索历史 清除

医学文献 >>
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
知识库 >>
  • 临床诊疗知识库
  • 中医药知识库
评价分析 >>
  • 机构
  • 作者
热搜词:
换一批

二尖瓣形态对经皮球囊二尖瓣成形术近远期疗效的影响

The impact of mitral valve morphology on the short and long-tern outcome post percutaneous balloon mitral valvuloplasty in patients with mitral valve stenosis

摘要:

目的 观察不同瓣膜形态的二尖瓣狭窄患者行经皮球囊二尖瓣成形术的近远期疗效.方法 根据Wilkins超声二尖瓣形态学积分,将385例二尖瓣狭窄患者分为>8分组(125例)和≤8分组(260例).均采用改良Inoue法对患者行经皮球囊二尖瓣成形术.术后进行随访,并比较两组患者的临床疗效.结果 经皮球囊二尖瓣成形术成功370例,>8分组经皮球囊二尖瓣成形术的成功率低于≤8分组(92.8%比97.7%,P<0.05).术后6个月,两组患者各项超声心动图检查指标均较术前显著改善(均P<0.05);与≤8分组(254例)比较,>8分组(116例)经皮球囊二尖瓣成形术后左心房平均压、肺动脉收缩压、跨瓣压差及二尖瓣瓣口面积的改变值均较小[分别为(14.22±5.02)mm Hg(1 mm Hg=0.133 kPa)比(15.44±5.19) mm Hg、(26.13±9.27) mm Hg比(31.93±9.98)mm Hg、(9.21±4.11)mm Hg比(10.16 ±4.21)mm Hg和(1.02±0.15)cm2比(1.20±0.22)cm2,均P<0.05].经皮球囊二尖瓣成形术成功且完成远期随访[(78±20)个月]的患者共353例,两组患者各项超声心动图检查指标均较术前显著改善(均P<0.05);与≤8分组(245例)比较,>8分组(108例)左心房平均压、肺动脉收缩压、跨瓣压差及二尖瓣瓣口面积的改变值均较小[分别为(13.28±5.06) mm Hg比(14.77±5.17)mm Hg、(21.19±9.17) mm Hg比(28.92±9.91) mm Hg、(7.30±4.40)mm Hg比(9.16±4.28)mm Hg和(0.92±0.17)cm2比(1.07±0.20)cm2,均P<0.05],且再狭窄发生率较高(20.4%比8.2%,P<0.05).结论 二尖瓣瓣膜形态是决定经皮球囊二尖瓣成形术疗效的关键因素之一.对于超声二尖瓣形态学积分低的患者,经皮球囊二尖瓣成形术成功率较高,术后近期及远期随访疗效较好,再狭窄发生率较低,治疗方案可优先选择经皮球囊二尖瓣成形术.

更多
abstracts:

Objective To investigate the short and long-term outcome post percutaneous balloon mitral valvuloplasty ( PBMV ) in mitral valve stenosis patients with different mitral valve morphology.Methods Mitral valve morphology was graded according to the Wilkins scoring system,385 eligible patients were divided into echocardiographic scores > 8 group ( n = 125 ) and ≤ 8 group ( n = 260).Patients were followed up after PBMV according to the improved Inoue method.Results PBMV was successful in 370 patients,the success rate of PBMV in > 8 group was significantly lower than in ≤8 group (92.8% vs.97.7%,P <0.05).Hemodynamic parameters improved significantly in both groups (all P <0.05 ) at 6 months post PBMV.Compared to pre-PBMV,improvement on left atrial mean pressure [ ( 14.22 ± 5.02) mm Hg vs.( 15.44 ± 5.19 ) mm Hg ( 1 mm Hg = 0.133 kPa) ],pulmonary artery systolic pressure [ ( 26.13 ± 9.27 )mm Hg vs.(31.93 ± 9.98 ) nun Hg ],mitral valve gradient [ (9.21 ± 4.11 ) mm Hg vs.( 10.16 ± 4.21 )mm Hg ] and area of mitral valve orifice [ ( 1.02 ± 0.15 ) cm2 vs.( 1.20 ± 0.22 ) cm2 ] post PBMV was less in > 8 group ( 116 cases) than those in ≤ 8 group ( 254 cases,all P < 0.05 ).Three hundreds and fifty three patients were followed up for (78 ±20) months.Echocardiographic parameters post PBMV improved significantly in both groups compared with the pre-PBMV values during follow-up (all P <0.05).However,left atrial mean pressure,pulmonary artery systolic pressure,mitral valve gradient and area of mitral valve orifice in >8 group ( 108 cases) improved less than those in ≤8 group (245 cases)[(13.28 ±5.06) mm Hg vs.(14.77 ±5.17) mm Hg,(21.19 ±9.17) mm Hg vs.(28.92 ±9.91)mm Hg,(7.30 ±4.40) mm Hgvs.(9.16±4.28) mm Hg,(0.92±0.17) cm2 vs.(1.07 ±0.20) cm2;all P <0.05].The incidence of mitral restenosis was also significantly higher in >8 group than in ≤8 group (20.4% vs.8.2%,P < 0.05 ).Conclusions The mitral valve morphology played a key role on the outcome post PBMV in patients with mitral valve stenosis.Patients with lower echocardiographic scores benefit more from PBMV than patients with higher echocardiographic scores.

More
作者: 张领 [1] 卫玮 [2] 岳修宇 [1] 石振刚 [1]
期刊: 《中华心血管病杂志》2011年39卷12期 1124-1128页 MEDLINEISTICPKUCSCD
分类号: R714.252
栏目名称: 临床研究
DOI: 10.3760/cma.j.issn.0253-3758.2011.12.009
发布时间: 2012-03-06
基金项目:
河南省卫生科技创新型人才工程专项经费资助项目
  • 浏览:348
  • 下载:48

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

  • 客服热线:4000-115-888 转3 (周一至周五:8:00至17:00)

  • |
  • 客服邮箱:yiyao@wanfangdata.com.cn

  • 违法和不良信息举报电话:4000-115-888,举报邮箱:problem@wanfangdata.com.cn,举报专区

官方微信
万方医学小程序
new翻译 充值 订阅 收藏 移动端

官方微信

万方医学小程序

使用
帮助
Alternate Text
调查问卷