冠心病患者发生二尖瓣脱垂样改变超声心动图特点分析

目的探讨冠心病患者发生二尖瓣脱垂样改变的超声心动图特点,并分析其对治疗策略的影响。方法选取北部战区总医院收治的同时行冠状动脉旁路移植与二尖瓣手术的171例患者为研究对象。根据冠状动脉病变严重程度将其分为A组(病变支数≥3支,n=98)与B组(病变支数1~2支,n=73)。另选取我院同期收治的二尖瓣脱垂无冠心病行二尖瓣手术72例患者为C组。收集3组患者的临床资料及术前超声心动图数据。结果 A组患者的肺动脉收缩压、左房直径、收缩期峰速(Sm′、St′、Si′)均明显小于B组、C组,差异均有统计学意义(P<0.05)。A组患者二尖瓣病变发生在A2区的比例明显高于B组、C组,差异有统计学意义(P<0.05)。结论冠心病患者的二尖瓣脱垂样改变始发于冠心病,但已经具有独立临床特点,需要在血运重建时同期处理二尖瓣病变。

Echocardiographic characteristics of mitral valve prolapse in patients with coronary heart disease

Objective To investigate the echocardiography characteristics of mitral valve prolapse in patients with coronary heart disease(CHD)and to analyze its influence on treatment strategy.Methods A retrospective study was performed on 171 cases of patients who underwent coronary artery bypass grafting and mitral valve surgery.Acording to the severity of CHD,patients were divided into the Group A(the number of lesions≥3,n=98)and Group B(1-2 lesions,n=73).In addition,72 patients undergoing mitral valve surgery for mitral valve prolapse without CHD during the same period were selected as Group C.Clinical data and preoperative echocardiographic data were collected from 3 groups of patients.Results The pulmonary artery systolic blood pressure,left atrial diameter,and systolic peak velocity(Sm′,St′,Si′)in Group A were significantly lower than those in Group B and Group C,and the differences were statistically significant(P<0.05).The proportion of mitral valve lesions in area A2 in Group A was significantly higher than those in Group B and Group C(P<0.05).Conclusion Mitral valve prolapse in patients with CHD is originally caused by CHD,but has independent clinical characteristics,requiring simultaneous management of mitral valve lesions during revascularization.