左房室瓣口平均压与峰值压比值对重度左房室瓣狭窄合并左房室瓣反流患者的评估价值

摘要

Objective The aim of this study is to determine the prognostic values of a ratio of mean pressure gradient ( MPG ) to peak pressure gradient ( PPG ) across the stenotic mitral valve orifice in patients with severe mitral stenosis ( MS ) and coexisting mitral regurgitation ( MR ). Methods A total of 68 patients with simple rheumatic mitral lesions ( severe mitral stenosis ) were enrolled in this study and divided into 3 groups according to the ratio of color mitral regurgitation area to left atrial area ( MR/LA) by echocardiography. Bivariate correlations were evaluated using Pearson's correlation coefficient. The discriminatory ability of MPG/PPG ratio for MR was assessed using the receiver operating characteristic curve ( ROC ). Results The MPG/PPG ratio was correlated with MR/LA by echocardiography ( r = -0. 812, P ＜ 0. 001 ). The sensitivity and specificity were 80% and 73% respectively with MPG/PPG≤0. 544 defined as the diagnosis criterion for moderate or severe MR; the sensitivity and specificity were 81% and 91% respectively with MPG/PPG ≤0. 412 defined as the diagnosis criterion for severe MR. Conclusion The MPG/PPG ratio across the stenotic mitral valve orifice from echocardiography displays satisfiable prognostic values in evaluating the degrees of severe mitral stenosis with coexisting severe MR.%目的 探讨左房室瓣口平均压与峰值压比值(MPG/PPG)对重度左房室瓣狭窄合并左房室瓣反流患者的临床价值.方法 以超声心动图测定MPG/PPG,采用受试者工作特征曲线(ROC)评价MPG/PPG对以二维面积法确定的68例单纯性风湿性重度左房室瓣狭窄患者合并左房室瓣反流患者的诊断价值.结果 重度左房室瓣狭窄患者MPG/PPG与合并左房室瓣反流程度(MR/LA)呈负相关关系(r=-0.812,P＜0.001).选取MPG/PPG≤0 544为诊断重度左房室瓣狭窄合并中度以上左房室瓣反流的界点时,敏感性和特异性分别是80%和73%.选取MPG/PPG≤0 412为诊断重度左房室瓣反流的界点时,敏感性和特异性分别是81%和91%.结论 超声心动图左房室瓣口MPG/PPG可以用来评估重度左房室瓣狭窄患者合并左房室瓣反流的程度.