158例钙化性心脏瓣膜病的临床分析.DOCVIP

临床医学论文-158例钙化性心脏瓣膜病的临床分析 ???????????? 作者：黄碧宏, 汪花香, 邱汉婴 【关键词】? 心脏瓣膜病 ??? 摘要:目的:探讨老年性钙化性心脏瓣膜病的临床特点及其与冠心病的关系。方法:回顾分析1998年至2004 年间652例60岁住院老年人的超声心动图及临床资料。结果：钙化性瓣膜病的发生部位以主动脉瓣最多见;经过临床诊断确诊为冠心病的有425例，以ACS为主，其次是陈旧性心肌梗死，稳定型心绞痛。钙化性心脏瓣膜病与血糖、血压、血超敏C反应蛋白（CRP）、血脂异常、冠心病高有关，钙化组的总胆固醇( TC) 、甘油三酯( TG) 、低密度脂蛋白(LDL) 均明显高于非钙化组(P0.001)。在钙化组, 冠心病的患病率明显高于非钙化组(P0.01)。结论：钙化性心脏瓣膜病与冠心病、高血压病、血脂异常、血糖、血超敏C反应蛋白关系密切, 超声心动图可作为常规检查手段。CRP可以作为预测心脏钙化性瓣膜病的指标。 　　关键词:? 心脏瓣膜病;? 钙化；? 超声心动图;? C反应蛋白 　　Clinical Analysis of? Calcified Valvular Disease in 58 Cases Patients Elderly 　　Abstract: Objective: To discuss the clinical features of calcified valvular disease? in the elderly. And to analysis the relation between the calcified valvular disease with the coronary heart disease.Methods: Five hundred and fifty two patients , at the age of over 60 years , with calcified valvular disease were retrospectively analyzed from 1998 to 2004. Results: The most? valvular lesions of calcified valvular disease is aortic? valvular; The case of calcified valvular disease combined with coronary heart disease is 425, the most is ACS, then chronic myocardiac infarction, stable angina pectoris. calcified valvular disease is related to hyperglucose, hypertension, C Reacting Protein(CRP)，hyperlipemia，and coronary heart disease. Conclusions: The? calcified valvular disease in elder is more association with hyperglucose, hypertension, C Reacting Protein(CRP)，hyperlipemia，and coronary heart disease. Ultrasonocardiogram can be used as a conventional method for examination of? calcified valvular disease in the elderly. The? C Reacting Protein(CRP) can predict to calcified valvular disease in elder. 　　Key words:? PValvular disease;? Ultrasonocardiogram;? Calcification;? C reacting protein 　　钙化性心脏瓣膜病是一种随年龄而增加的以瓣膜内大量钙质沉积为特征的老年人常见的心脏瓣膜病变。随着人类寿命的延长,老年人此病的发生率日益增加,在西方发达国家,该疾病的发生仅次于冠心病和高血压;并随着风湿性心脏病发病率的降低,该疾病已经成为老年人瓣膜置换的首要病因［1］。过去本病一直认为是一种退行性病变，是由于长期的瓣叶磨损，被动性的钙质沉着而造成的老年性疾病。现在越来越多的组织病理学和临床资料证据表明，该病也是一个与动脉的粥样硬化病理过程类似的慢性炎症，瓣叶的钙化是一个主动的过程，与脂质的沉着有关。钙化