本文選題：主動脈瓣狹窄 + 心臟瓣膜假體植入　； 參考：《中國循環(huán)雜志》2017年06期

【摘要】：目的:探討主動脈瓣狹窄患者經(jīng)導管主動脈瓣置換(TAVR)術(shù)后6個月內(nèi)心功能、主動脈瓣跨瓣壓差及血流速度特點,以明確TAVR術(shù)后心功能、主動瓣跨瓣壓差的變化規(guī)律,為臨床治療提供指導信息。方法:2013-12至2015-12連續(xù)入選常規(guī)外科換瓣手術(shù)禁忌或美國胸外科醫(yī)師學會(STS)評分高危、在我院成功行TAVR治療的49例重度主動脈瓣狹窄患者。在TAVR治療前后、術(shù)后1個月及6個月時,所有患者接受超聲心動圖檢查和血N末端B型利鈉肽原(NT-pro BNP)檢測,記錄左心室射血分數(shù)、主動脈瓣平均跨瓣壓差、最大跨瓣壓差、最大跨瓣血流速度和血NT-pro BNP濃度。TAVR術(shù)前左心室射血分數(shù)50%的患者分入心功能不全組,左心室射血分數(shù)≥50%的患者分入心功能正常組,觀察兩組患者TAVR術(shù)后心功能和NT-pro BNP濃度變化。結(jié)果:49例患者中,心功能不全組15例(30.6%),心功能正常組34例(69.4%)。TAVR治療后7 d內(nèi),所有患者的左心室射血分數(shù)[(56.0±14.6)%vs(52.5±13.8)%]、主動脈瓣平均跨瓣壓差[(11±5)mmH g(1 mmH g=0.133 kP a)vs(58±18)mmH g]、最大跨瓣壓差([21.7±9.5)mmH g vs(93.0±28.6)mmH g]、最大跨瓣血流速度([2.3±0.5)m/s vs(4.8±0.7)m/s]、血NT-proB NP濃度[1 831(1 098~3 363)pg/ml vs 3 842(1 763~8 664)pg/ml]、主動脈瓣瓣口面積[(1.57±0.43)cm2 vs(0.58±0.23)cm2]較術(shù)前均有明顯改善,差異均有統(tǒng)計學意義(P均0.05)。術(shù)后6個月內(nèi),患者的左心室射血分數(shù)仍持續(xù)上升,尤以心功能不全組為著;主動脈瓣平均跨瓣壓差、最大跨瓣血流速度、NT-proB NP濃度較術(shù)后持續(xù)下降,紐約心臟協(xié)會心功能分級持續(xù)改善,差異均有統(tǒng)計學意義(P均0.05)。結(jié)論:TAVR是外科手術(shù)禁忌或STS評分高危的重度主動脈瓣狹窄患者的一種有效治療方式,在6個月內(nèi)可明顯且持續(xù)改善患者的心功能,左心功能不全患者改善尤為明顯。
[Abstract]:Objective: to investigate the characteristics of cardiac function, aortic valve pressure difference and blood flow velocity in patients with aortic stenosis within 6 months after transcatheter aortic valve replacement (TAVRV). To provide guidance information for clinical treatment. Methods from 2013-12 to 2015-12, 49 patients with severe aortic valve stenosis who had been successfully treated with TAVR in our hospital were enrolled in the routine surgical valve replacement surgery taboo or the American College of Thoracic Surgeons (ASS) score. Before and after TAVR, 1 month and 6 months after TAVR, all patients were examined by echocardiography and NT-pro BNPs. The left ventricular ejection fraction (LVEF), the mean transvalve pressure difference of aortic valve and the maximum transvalvular pressure difference were recorded. Patients with 50% left ventricular ejection fraction (LVEF) and 鈮，

本文編號：1817507