心胸比对左心瓣膜返流患者左心室扩大预示价值的临床研究.docVIP

【摘要】 目的 比较左心瓣膜返流患者的X光胸片心胸比与心脏彩超左室直径以讨论其相关性。方法 本研究纳入了98例（男性患者55例，女性患者43例）年龄在30～76岁（45±31.8）的单纯性二尖瓣或主动脉瓣关闭不全的患者（68例二尖瓣返流患者，30例主动脉瓣返流患者）。对于每位患者在同一天进行胸片及心脏多谱勒超声检测。结果 在17例轻度二尖瓣狭窄患者中，有2例（11.7%）胸片提示心脏扩大，而3例患者（17.6%）心脏超声显示左心室扩大。在31例二尖瓣中度返流的患者中，7例患者（22.5%）的胸片显示出心脏的扩大，而有13例患者（41.9%）的患者心脏彩超提示左心室扩大。在20例重度二尖瓣狭窄的患者中，9例患者（45%）胸片提示心脏扩大，而有14例患者（70%）心脏超声提示左室扩大。在21例轻至中度主动脉瓣返流的患者中，胸片提示1例患者（5%）的心脏扩大，而心脏超声则提示7例患者（35%）左室扩大。在9例重度主动脉狭窄的患者中，5例（55.6%）的胸片提示心脏扩大，而所有9例患者（100%）的心脏超声结果提示左心室扩大。结论 左心瓣膜返流严重程度，特别是主动脉瓣返流与心脏超声检测结果有较好的相关性。而胸部平片对左心瓣膜返流的预示价值低。 【关键词】 胸片； 心脏超声； 心胸比； 心脏瓣膜关闭不全； 左心室扩大 Predictive Value of Cardiothoracic Ratio as a Marker of Left Ventricler Enlargement in Patients with Left Heart Valvular Regurgitation CHEN Zhongjun， ZHONG Ling(The First Peoples Hospital of Sichuan Ziyang,Sichuan Ziyang 641300,China) 【Abstract】 Objective To compare the cardiothoracic ratio on chest radiography and left ventricular dimensions from echocardiography in patients with left heart valvular regurgitatio and discuss its correlation. Methods The studied population consisted of 98 patients (55 male, 43 female) aged 3076 years (45±31.8 years) with isolated mitral or aortic regurgitation. Chest radiography and echocardiographic examination were performed on the same day for every patient. Results Among 31 patients with moderate mitral regurgitation, cardiac enlargement was found in 7 (22.5%) patients on chest radiography, and in 13 (41.5%) patients on echocardiography. Among 20 patients with severe mitral regurgitation, cardiothoracic ratio was abnormal in 9 (45%) patients whereas cardiac enlargement was documented in 14 (70%) patients on echocardiography. Although there was one patient with cardiac enlargement (CE) on chest radiography in the groups of mild and moderate aortic regurgitation, 55.6% of patients in the group of　severe aortic regurgitation had CE on chest radiography. Cardiac enlargement was detected in 60% patients with moderate and 100% patients with severe aortic regurgit