| 摘要: |
| 目的 应用实时三维经食管超声心动图(real-time three-dimensional transesophageal echocardiography, RT-3D-TEE)定量分析主动脉瓣反流(aortic regurgitation, AR)患者主动脉根部解剖参数,筛选显著影响AR的参数,进一步揭示AR的机制,为临床提供更多信息。 方法 选取AR患者42例作为反流组,无AR患者30例作为对照组,应用RT-3D-TEE采集两组患者的图像并进行脱机分析,分别测得主动脉根部主动脉瓣环(AA)、主动脉窦部(SOV)及窦管结合部(STJ)三个水平的9个参数：主动脉根部内径(AAD、SOVD、STJD),主动脉根部面积(AAA、SOVA、STJA),主动脉根部周长(AAC、SOVC、STJC)。将两组参数进行统计学分析,纳入Logistic回归模型,对进入Logistic回归的参数绘制ROC曲线。结果 ①反流组的SOVD、STJD、AAA、SOVA、STJA、AAC、SOVC、STJC较对照组均增大(P＜0.05),其余参数两组间比较无统计学差异(P＞0.05); ②多因素逻辑回归模型逐步筛选显著影响AR的因素,筛选出STJA和STJC对AR有显著影响,P值分别为0.002、0.005; ③ROC曲线分析结果显示STJA和STJC曲线下面积分别为0.867、0.885。 结论 主动脉瓣反流时主动脉根部主动脉瓣环、主动脉窦部及窦管结合部三个水平参数增大程度不同,其中窦管结合部水平面积及周长变化显著,是导致AR的重要因素。 |
| 关键词: 经食管超声心动图 主动脉瓣反流 解剖结构 |
| DOI： |
| 投稿时间：2019-07-10修订日期：2019-08-01 |
| 基金项目: |
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| Quantification Analysis of the leaflet anatomy in aortic regurgitation patients using real-time three-dimensional echocardiography.FU Xin*, XIONG Ming-chen*, QU Shao-hui, Wu Jia-rong, TIAN Jia-wei. Department of Ultrasound, the Second Affiliated Hospital, Harbin Medical University, Harbin 150086, China |
| fuxin |
| () |
| Abstract: |
| Objective Apply real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) in aortic regurgitation(AR) patients to quantitatively analysis the aortic root anatomical characteristics and screening the parameters which significantly affect AR to further reveal the mechanism of AR and provide clinical more information. Methods 42 patients with AR were enrolled as AR group and 30 cases of non-AR people were involved as control group. RT-3D-TEE was using to collect images in two groups and offline analysis was performed. 3 sets of parameters of the aortic root : root diameter (AAD、SOVD、STJD) ; root area (AAA、SOVA、STJA) ; root circumference (AAC、SOVC、STJC) were acquired. Parameters of two groups were compared, and the parameters were incorporated into the logistic regression model, then the ROC curves were obtained. Results ①Compared with the control group, SOVD、STJD、AAA、SOVA、STJA、AAC、SOVC、STJC in AR group increased (P＜0.05),while the rest parameters had no statistical differences (P＞0.05)；② Multivariable logistic regression model gradually screening of the significant factors influencing the reflux, and as a result STJA and STJC had significant influence on AR, P values were 0.002、0.005；③ The ROC curve analysis showed that the area of STJA or STJC curve were both greater than 0.5, which were 0.867 and 0.885 separately. Conclusions In AR patients, parameters in three levels of aortic root-aortic annulus, sinus of valsava and sinus tube junction- increased differently. The area and circumference of the sinus tube junction changed significantly, and this might be one of the possible mechanism of AR. |
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