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目的分析老年退行性心脏瓣膜病病人超声心动图的演变及检出特点,探讨早期诊断的可能性。方法对52例65～100岁的临床资料完整、随访2～12年的老年人多次的超声心动图检查结果进行回顾性分析,按末次超声心动图结果分为正常组、老年退行性心脏瓣膜病组及瓣膜功能异常组。根据首次超声心动图检查特征,分析老年退行性心脏瓣膜病组及瓣膜功能异常组检出方式,比较两组瓣膜损害程度及临床情况。结果 52例中老年退行性心脏瓣膜病组27例(51.9%),以3种方式检出;瓣膜功能异常组14例(26.9%),均为多瓣膜轻度反流,以2种方式检出;3个以上瓣膜轻度反流的老年退行性心脏瓣膜病组16例(59.3%),瓣膜功能异常组3例(21.4%)(P<0.05);老年退行性心脏瓣膜病组与瓣膜功能异常组比较,合并心电图传导阻滞改变、X 线示主动脉钙化病变及发生急性心血管事件例数有显著性差异(P<0.05)。结论多瓣膜轻度反流是老年退行性心脏瓣膜病演变过程中的早期特征性表现。既往超声心动图检查正常的老年人,增龄后逐渐出现多瓣膜轻度反流,应考虑为老年退行性心脏瓣膜病的早期表现;对伴有主动脉钙化及(或)传导阻滞心电图的老年人,应及时行超声心动图检查,及早发现心脏瓣膜的结构改变。
Objective To analyze the evolution and characteristics of echocardiography in elderly patients with degenerative heart valvular disease and to explore the possibility of early diagnosis. Methods The clinical data of 52 patients aged 65 to 100 years were followed up for 2 to 12 years. The results of multiple echocardiography were retrospectively analyzed. According to the results of the last echocardiography, they were divided into normal group, senile degenerative heart valve Disease group and valve dysfunction group. According to the characteristics of the first echocardiography, the detection methods of senile degenerative valvular heart disease group and valvular dysfunction group were analyzed. The degree of valve damage and clinical situation were compared between the two groups. Results Twenty-two patients (51.9%) with degenerative heart valve disease were detected in three ways in 52 cases of middle-aged patients with degenerative valvular heart disease. Fourteen patients (26.9%) with abnormal valvular function were all suffered from mild multi-valve regurgitation. (59.3%) and 3 patients (21.4%) with valvular dysfunction group (P <0.05). More than 3 patients with senile degenerative valvular heart disease and valve Compared with abnormal function group, there were significant differences (P <0.05) in combined electrocardiographic block, X-ray showed aortic calcification lesions and acute cardiovascular events. Conclusions Mild valvular regurgitation is an early characteristic manifestation of the degenerative valvular heart disease in the elderly. Previous echocardiography in elderly patients with normal, gradually multi-valve mild reflux after aging, should be considered for the elderly degenerative heart valve disease early manifestations; associated with aortic calcification and (or) block electrocardiogram Elderly, echocardiography should be promptly line examination, early detection of structural changes in the heart valve.