洪冰 胡颖飞 陈娟

摘 要 目的：探討超声诊断老年性心脏瓣膜退行性病变的效果。方法：将2018年1月至2018年7月在江西新余市中医院进行超声检查的60例老年性心脏瓣膜退行性病变患者纳入观察组，将同期进行常规体检的60例健康志愿者纳入对照组。观察组中男性33例，女性27例，年龄为61～80岁，平均年龄为（63.24±5.85）岁；对照组中男性35例，女性25例，年龄为50～80岁，平均年龄为（60.29±5.93）岁。两组对象均常规进行心脏超声检查，比较两组对象心脏瓣膜超声检查相关参数，分析老年性心脏瓣膜退行性病变钙化检出情况及超声诊断效果。结果：观察组患者瓣环周长、瓣环前外侧交界至后侧交界距离、瓣环投影面积、瓣叶前叶瓣根至对合线长度、瓣叶后叶瓣根至对合线长度、瓣叶前叶瓣体面积均高于对照组，差异均有统计学意义（P<0.05）；老年性心脏瓣膜退行性病变患者中的主动脉瓣钙化检出率高于二尖瓣钙化，差异有统计学意义（P<0.05）；超声诊断老年性心脏瓣膜退行性病变的敏感度、特异度、准确率、阳性预测值、阴性预测值均超过95%。结论：老年性心脏瓣膜退行性病变患者的心脏瓣膜相关参数存在显著变化，多数患者钙化位置为主动脉瓣。超声诊断早期老年性心脏瓣膜退行性病变效果良好。

关键词 心脏瓣膜退行性病变；超声诊断；钙化位置；心脏瓣膜相关参数

中图分类号：R542.5 文献标志码：A 文章编号：1006-1533（2019）06-0038-03

Evaluation of ultrasound in the diagnosis of senile cardiac valve degenerative diseases

HONG Bing， HU Yingfei， CHEN Juan

（Functional Department of Hospital of Traditional Chinese Medicine of Xinyu， Xinyu 338000， Jiangxi Province， China）

ABSTRACT Objective： To investigate the effect of ultrasound in the diagnosis of senile cardiac valve degenerative diseases. Methods： Sixty patients with senile cardiac valve degenerative diseases who underwent ultrasonography at Xinyu Hospital of Traditional Chinese Medicine from January to July 2018 were included in the observation group， and sixty healthy volunteers who underwent routine physical examination during the same period were included in the control group. There were 33 males and 27 females in the observation group， the age ranged from 61 to 80 years， and the average age was （63.24±5.85） years old； in the control group， there were 35 males and 25 females， the age ranged from 50 to 80 years， and the average age was （60.29±5.93） years old. Cardiac ultrasonography was routinely performed in the two groups， and the parameters of heart valve ultrasound examination were compared between the two groups， and the detection of calcification in senile cardiac valve degenerative diseases and the diagnostic effect of ultrasonography were analyzed. Results： The circumference of the annulus， distance from anterolateral to posterior junctions of annulus valves， the projection area of the annulus， the length from the root of the anterior leaflet to the convolution line， the length from the root of the posterior leaflet to the convolution line， and the anterior leaflet area of the valve leaflets of the patients in the observation group were higher than those in the control group， and the difference was statistically significant（P<0.05）. The detection rate of aortic valve calcification in patients with senile cardiac valve degenerative diseases was higher than that of mitral calcification（P<0.05）. The sensitivity， specificity， accuracy， positive predictive value and negative predictive value of ultrasonography in the diagnosis of senile cardiac valve degenerative diseases were all over 95%. Conclusion： There are significant changes in valvular parameters in elderly patients with cardiac valve degenerative diseases. Most patients have a calcified position in the aortic valve. Ultrasound diagnosis of early senile cardiac valve degenerative disease is effective.