孤立性主动脉瓣狭窄病因的超声分析

为明确超声心动图检查中，孤立性主动脉瓣狭窄（ＡＳ）的病因及相应的影像特点，对１９９０年以来在我院超声心动图室发现的６６例孤立性ＡＳ（４４例合并关闭不全）进行分析。结果为先天性二瓣畸形（４８．５％），退行性病变（２１％），风湿病变（１５．２％）是ＡＳ的主要病因。但老年组（年龄＞６５岁），以退行性病变为主（６６．６％）。它导致主动脉瓣狭窄最晚，平均６７岁，先天性二叶瓣畸形，平均４９岁，风湿病变，平均４３岁。先天性二瓣畸形及退行性病变引起的瓣膜狭窄与瓣叶的增厚、钙化及固定有关，无或仅有轻微的连合处融合，风湿病变以连合处的融合为特点。研究表明：年龄对孤立性主动脉瓣狭窄的病因诊断有重要的影响；不同病因导致的主动脉瓣狭窄有不同的超声影像特点。

Etiological Diagnosis of Isolated Aortic Valve Stenosis with Echocardiography

To determine the etiological proportion of isolated aortic valve stenosis(AS)in echocardiography and the corresponding ultrasonic imaging feature,the echocardiograms of 66 patients with isolated AS found in our hospital since 1990 were analyzed.In over 90%of the stenotic aortic valves,the etiology is one of following three types:congenital bicuspid deformity(48.5%),degenerative(21%)or rheumatic(15.2%)disease.In the senile group(>65yrs),degenerative valve stenosis was most frequent(66.6%).The stenosis occurred latest in patients with degenerative valve,ealier in those with congenital bicuspid valve(mean age 49 yrs)and rheumatic valve(mean age 43 yrs).The degree of congenital and degenerative aortic stenosis was correlated with the fibrous thickening and calcification of leaflets and annulus with no or slight commisural fussion present.While rheumatic aortic valve stenosis was characterized by at least one,generally two or three commissures fussion.Our obervation suggests:age has important impact on the etiological diagnosis of isolated AS;the echocardiogram of AS with different causes has different feature.