洪冰 胡穎飛 陳娟

摘 要 目的：探討超聲診斷老年性心臟瓣膜退行性病變的效果。方法：將2018年1月至2018年7月在江西新余市中醫(yī)院進(jìn)行超聲檢查的60例老年性心臟瓣膜退行性病變患者納入觀察組，將同期進(jìn)行常規(guī)體檢的60例健康志愿者納入對(duì)照組。觀察組中男性33例，女性27例，年齡為61～80歲，平均年齡為（63.24±5.85）歲；對(duì)照組中男性35例，女性25例，年齡為50～80歲，平均年齡為（60.29±5.93）歲。兩組對(duì)象均常規(guī)進(jìn)行心臟超聲檢查，比較兩組對(duì)象心臟瓣膜超聲檢查相關(guān)參數(shù)，分析老年性心臟瓣膜退行性病變鈣化檢出情況及超聲診斷效果。結(jié)果：觀察組患者瓣環(huán)周長(zhǎng)、瓣環(huán)前外側(cè)交界至后側(cè)交界距離、瓣環(huán)投影面積、瓣葉前葉瓣根至對(duì)合線長(zhǎng)度、瓣葉后葉瓣根至對(duì)合線長(zhǎng)度、瓣葉前葉瓣體面積均高于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）；老年性心臟瓣膜退行性病變患者中的主動(dòng)脈瓣鈣化檢出率高于二尖瓣鈣化，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；超聲診斷老年性心臟瓣膜退行性病變的敏感度、特異度、準(zhǔn)確率、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值均超過(guò)95%。結(jié)論：老年性心臟瓣膜退行性病變患者的心臟瓣膜相關(guān)參數(shù)存在顯著變化，多數(shù)患者鈣化位置為主動(dòng)脈瓣。超聲診斷早期老年性心臟瓣膜退行性病變效果良好。

關(guān)鍵詞 心臟瓣膜退行性病變；超聲診斷；鈣化位置；心臟瓣膜相關(guān)參數(shù)

中圖分類(lèi)號(hào)：R542.5 文獻(xiàn)標(biāo)志碼：A 文章編號(hào)：1006-1533（2019）06-0038-03

Evaluation of ultrasound in the diagnosis of senile cardiac valve degenerative diseases

HONG Bing， HU Yingfei， CHEN Juan

（Functional Department of Hospital of Traditional Chinese Medicine of Xinyu， Xinyu 338000， Jiangxi Province， China）

ABSTRACT Objective： To investigate the effect of ultrasound in the diagnosis of senile cardiac valve degenerative diseases. Methods： Sixty patients with senile cardiac valve degenerative diseases who underwent ultrasonography at Xinyu Hospital of Traditional Chinese Medicine from January to July 2018 were included in the observation group， and sixty healthy volunteers who underwent routine physical examination during the same period were included in the control group. There were 33 males and 27 females in the observation group， the age ranged from 61 to 80 years， and the average age was （63.24±5.85） years old； in the control group， there were 35 males and 25 females， the age ranged from 50 to 80 years， and the average age was （60.29±5.93） years old. Cardiac ultrasonography was routinely performed in the two groups， and the parameters of heart valve ultrasound examination were compared between the two groups， and the detection of calcification in senile cardiac valve degenerative diseases and the diagnostic effect of ultrasonography were analyzed. Results： The circumference of the annulus， distance from anterolateral to posterior junctions of annulus valves， the projection area of the annulus， the length from the root of the anterior leaflet to the convolution line， the length from the root of the posterior leaflet to the convolution line， and the anterior leaflet area of the valve leaflets of the patients in the observation group were higher than those in the control group， and the difference was statistically significant（P<0.05）. The detection rate of aortic valve calcification in patients with senile cardiac valve degenerative diseases was higher than that of mitral calcification（P<0.05）. The sensitivity， specificity， accuracy， positive predictive value and negative predictive value of ultrasonography in the diagnosis of senile cardiac valve degenerative diseases were all over 95%. Conclusion： There are significant changes in valvular parameters in elderly patients with cardiac valve degenerative diseases. Most patients have a calcified position in the aortic valve. Ultrasound diagnosis of early senile cardiac valve degenerative disease is effective.