CAJ | 학술논문

目的应用实时三维经食管超声心动图(RT-3D-TEE)定量分析主动脉瓣反流(AR)患者主动脉瓣叶解剖参数,筛选显著影响AR的参数.方法选取AR患者32例作为反流组,无AR患者20例作为对照组,应用RT-3D-TEE采集两组患者的图像并进行脱机分析,分别测得主动脉瓣左冠瓣、右冠瓣、无冠瓣三个瓣叶的12个参数:瓣叶游离缘长度(LL、RL、NL)、瓣叶高度(LH、RH、NH)、瓣叶游离缘长度/高度比值(LRa、RRa、NRa)、瓣尖到铰链平面距离(LTH、RTH、NTH).将两组参数进行统计学分析,纳入Logistic回归模型,对进入logistic回归的参数绘制ROC曲线.结果 ①反流组的LL、RL、NL、RH、LRa、NRa、RRa、RTH均较对照组增大(P＜0.05),其余参数两组间差异无统计学意义(P＞0.05);②Logistic回归模型逐步筛选显著影响AR的因素,筛选出RL和RTH对AR有显著影响,P值分别为0.001、0.011;③ROC曲线分析显示RL和RTH曲线下面积分别为0.811、0.605.结论瓣叶游离缘长度、瓣叶游离缘长度/高度比值的改变不均衡,右冠瓣各参数变化显著,是导致AR的重要因素.
목적 응용실시삼유경식관초성심동도(RT-3D-TEE)정량분석주동맥판반류(AR)환자주동맥판협해부삼수,사선현저영향AR적삼수.방법 선취AR환자32례작위반류조,무AR환자20례작위대조조,응용RT-3D-TEE채집량조환자적도상병진행탈궤분석,분별측득주동맥판좌관판、우관판、무관판삼개판협적12개삼수:판협유리연장도(LL、RL、NL)、판협고도(LH、RH、NH)、판협유리연장도/고도비치(LRa、RRa、NRa)、판첨도교련평면거리(LTH、RTH、NTH).장량조삼수진행통계학분석,납입Logistic회귀모형,대진입logistic회귀적삼수회제ROC곡선.결과 ①반류조적LL、RL、NL、RH、LRa、NRa、RRa、RTH균교대조조증대(P＜0.05),기여삼수량조간차이무통계학의의(P＞0.05);②Logistic회귀모형축보사선현저영향AR적인소,사선출RL화RTH대AR유현저영향,P치분별위0.001、0.011;③ROC곡선분석현시RL화RTH곡선하면적분별위0.811、0.605.결론 판협유리연장도、판협유리연장도/고도비치적개변불균형,우관판각삼수변화현저,시도치AR적중요인소.
Objective To quantitatively analysis the aortic valve leaf anatomical characteristics in aortic regurgitation(AR) patients by real-time three-dimensional transesophageal echocardiography (RT-3D-TEE),and screening the parameters which significantly affect AR to further reveal the mechanism of AR.Methods 32 patients with AR were enrolled as AR group and 20 cases of non-AR people were involved as control group.RT-3D-TEE was using to collect images in two groups and offline analysis was performed.4 sets of parameters of the aortic valves(left coronary valve,right coronary valve,and non-coronary valve):leaflet edge length(LL,RL,NL),leaflet height (LH,RH,N H),leaflet length/height ratio (LRa,RRa,NRa),leaflet tip plane distance(LTH,RTH,NTH) were acquired.Parameters of two groups were compared,and the parameters were incorporated into the logistic regression model,then the ROC curves were obtained.Results ①Compared with the control group,LL,RL,NL,RH,LRa,NRa,RRa in AR group increased (P ＜ 0.05),while the rest parameters had no statistical differences (P ＞0.05).②Multivariable logistic regression model gradually screening of the significant factors influencing the reflux,and as a result RL and RTH had significant influence on AR,P values were 0.001,0.011.③The ROC curve analysis showed that the area of RL or RTH curve were both greater than 0.5,which were 0.811 and 0.605 respectively.Conclusions The free edge length and free edge length/height ratio have changed unbalanced.Furthermore,right coronary valve parameters changed significantly,and this might be one of the possible mechanism of AR.