| 三尖瓣收缩期位移在风湿性二尖瓣病变患者中的临床意义 |
| 投稿时间：2016-08-10 修订日期：2016-08-28 点此下载全文 |
| 引用本文：贾静,步睿,吴建军,陈延军.三尖瓣收缩期位移在风湿性二尖瓣病变患者中的临床意义[J].医学研究杂志,2017,46(4):83-85,145 |
| DOI：
10.11969/j.issn.1673-548X.2017.04.021 |
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| 基金项目:黑龙江省自然科学基金资助项目（D201101） |
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| 中文摘要:目的 探讨三尖瓣收缩期位移（TAPSE）在风湿性心脏病二尖瓣狭窄合并反流患者中的临床意义。方法 连续性入选2014年1月1日~2015年12月31日就诊于哈尔滨医科大学附属第四医院心内科，经相关检查明确诊断为风湿性心脏病二尖瓣狭窄合并关闭不全患者，且均未行心外科手术治疗。入院后完善超声心动图测量、6分钟步行距离测试及血液生化标志物测定等相关检查。随访终止时间为终点事件发生时间或2016年6月10日，方式为门诊随访及电话随访。主要终点事件为：因心力衰竭再入院治疗；次要终点事件为：死亡或接受心脏外科手术治疗。结果 共入选风湿性心脏病二尖瓣狭窄合并关闭不全患者74例，包括男性9例，女性65例。其中53例患者合并心房颤动。TAPSE与血浆BNP水平、6min步行距离等均具有较好的相关性。应用ROC曲线选取TAPSE分界点为13.5mm（曲线下面积0.721，P=0.002）。TAPSE < 13.5mm组血浆BNP水平明显升高（P=0.000），6分钟步行距离明显降低（P=0.000）。Kaplan-Meier生存分析得出，TAPSE < 13.5mm组较TAPSE≥13.5mm组患者的预后差，再入院率明显升高（P=0.005）。结论 三尖瓣收缩期位移可以评价风湿性心脏病二尖瓣狭窄合并关闭不全患者的心功能，并可预测其再入院风险，与该类患者疾病预后相关。 |
| 中文关键词:三尖瓣收缩期位移 风湿性心脏病 二尖瓣狭窄 |
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| Clinical Significance of Tricuspid Annular Plane Systolic Excursion in Patients with Rheumatic Mitral Valve Disease |
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| Abstract:Objective To investigate the clinical significance of tricuspid annular plane systolic excursion (TAPSE) in patients with rheumatic mitral stenosis and regurgitation. Methods We prospectively studied the consecutive patients who were diagnosed as rheumatic mitral stenosis and regurgitation in the Fourth Hospital of Harbin Medical University between January 1, 2014 and December 31, 2015. No patients had been performed heart surgery ever. The biochemical markers, 6-minute walking distance test and echocardiography were measured. Clinical data was obtained by clinical visits or telephone interviews. The end point date was taken as the occurrence date of endpoint events or a censor date of 10 June, 2016. The primary endpoint events: rehospitalized for heart failure; secondary endpoint events: death or cardiac surgery. Results We enrolled 74 rheumatic mitral stenosis and regurgitation patients, including 9 males and 65 females. Of which 53 cases of patients had atrial fibrillation. TAPSE had good relation with serum BNP level and 6 minutes walking distance. The cut point of TAPSE was 13.5mm which was selected by receiver operating characteristic analysis (area under the curve 0.721, P=0.002). The patients with TAPSE <13.5mm had higher plasma BNP levels and poor 6-minute walk distance. By Kaplan-Meier survival curves, the survival of the subjects with TAPSE <13.5mm was significantly poor than those with TAPSE≥ 13.5mm (P=0.005). Conclusion TAPSE is a powerful variable to reflect heart function and predict the survival of re-hospitalization in patients with rheumatic mitral stenosis and regurgitation. |
| keywords:Tricuspid annular plane systolic excursion Rheumatic heart disease Mitral stenosis |
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