| 摘要: |
| 目的 探讨超声心动图在二叶式主动脉瓣畸形(BAV)患者随访和预后分析中的应用价值。方法 本研究为单中心回顾性临床研究。收集南京医科大学第一附属医院2013年1月至2019年12月经超声心动图诊断为 “二叶式主动脉瓣畸形”、临床资料和复查随访资料完整的患者,比较不同随访时长患者的占比,比较初诊和随访末次的瓣膜功能、主动脉功能变化情况,进一步纳入性别、年龄、形态学分型、主动脉瓣狭窄程度、返流程度、升主动脉内径等参数进行回归分析,寻找影响BAV预后的危险因素。结果 本研究共筛1154例BAV,纳入随访资料完整者243位(21.06%),随访逐渐延长,随访患者逐渐减少,而主动脉瓣功能障碍逐渐恶化、升主动脉内径逐渐增宽；初诊时年龄、初诊时AS程度、初诊时AR程度是BAV需要手术干预事件发生的相关危险因素；且年龄是影响预后的独立危险因素,其截断值为36岁,对是否发生手术时间预测的灵敏度为94.29%,特异度为39.49%；年龄≤36岁组5年内不发生手术事件的概率为92.39%；而年龄＞36岁组5年内不发生手术事件的概率仅为52.20%。结论 我国BAV人群随访率低；BAV引起的瓣膜功能障碍和升主动脉增宽具有时间累积效应；针对36岁以上BAV群体,尤应加强宣传教育,并建议每年连续随访心超以指导治疗。 |
| 关键词: 二叶式主动脉瓣 超声心动图 随访与指导 预后分析 |
| DOI： |
| 投稿时间：2022-08-30修订日期：2023-03-23 |
| 基金项目: |
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| Application value of echocardiography in follow-up and prognostic analysis of patients with bicuspid aortic valve |
| WU Tingting,PAN Haotian,ZHAO Kun,SUN Wei,ZHOU Bin,ZHOU Lei,YONG Yonghong,KONG Xiangqing |
| (The First Affiliated Hospital of Nanjing Medical University) |
| Abstract: |
| Objective To investigate the value of echocardiography in follow-up management and prognosis analysis of patients with bicuspid aortic valve (BAV). Methods This study was a single-center retrospective clinical study. Patients diagnosed as "bicuspid aortic valve malformation" by echocardiography in the First Affiliated Hospital of Nanjing Medical University with complete clinical data and follow-up data, from January 2013 to December 2019, were included to compare the proportion of patients with different follow-up duration, and to compare the changes of valve function and aortic function between the initial diagnosis and the last follow-up. Furthermore, gender, age, morphological type, degree of aortic stenosis, degree of regurgitation, and inner diameter of ascending aorta were included in the regression analysis to find the risk factors affecting the prognosis of BAV. Results A total of 1154 patients with BAV were screened out, and 243 patients (21.06%) with complete follow-up data were enrolled. With longer follow-up, patients number became less, aortic valve dysfunction worsened and the inner diameter of ascending aorta widened gradually. Age, degree of AS and degree of AR at initial diagnosis were related risk factors for BAV requiring surgical intervention. Age was found to be an independent risk factor for the prognosis of the disease by drawing the subject curve and survival curve. The cut-off value of age was 36 years, and the sensitivity and specificity were 94.29% and 39.49%, respectively. The probability of no surgical event within 5 years in group of age less than 36 was 92.39%, while in the group of age more than 36, the probability was only 52.20%. Conclusion The follow-up rate of BAV patients in China is low. Valvular dysfunction and ascending aorta widening induced by BAV showed a time cumulative effect. For BAV group over 36 years old, healthy education should be strengthened, and echocardiography examination was suggested every year continuously to guide treatment. |
| Key words: Bicuspid aortic valve echocardiography follow-up and guidance analysis of prognosis |
