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目的:探讨本地区主动脉瓣病变的病因特征和时代变迁,为主动脉瓣病变的诊治提供依据。方法:回顾分析我院不同时代的主动脉瓣置换术患者的临床资料,分析其病因特征,比较其时代差异。分别以主动脉瓣狭窄、主动脉瓣关闭不全、主动脉瓣狭窄合并关闭不全3组分析,具体病因包括风湿性、二叶式主动脉、退行性主动脉瓣、主动脉根部扩张、感染性心内膜炎、少见及未确定等6类病因。结果:风湿性、二叶式主动脉瓣、主动脉根部扩张以及退行性主动脉瓣病变是主要的病因类型,其中单纯主动脉瓣狭窄以风湿性(43例,占59.7%)及二叶瓣17例(23.6%)病因为主,单纯主动脉瓣关闭不全以根部扩张(38例,占43.2%)为主,主动脉瓣狭窄合并关闭不全则以风湿性(70例,占88.5%)为主。随着社会进步和人口老龄化,风湿性病因所占比例大幅下降,主动脉根部扩张导致的主动脉关闭不全有较大幅度的上升,退行性主动脉瓣有所上升,二叶式主动脉瓣、感染性心内膜炎所致瓣膜损害变化不明显。结论:主动脉瓣病因构成的改变及其特征对主动脉瓣临床诊治和医疗策略制定具有指导意义。
Objective: To investigate the etiological characteristics and changes of the age of aortic valve disease in our region and provide the basis for the diagnosis and treatment of aortic valve disease. Methods: The clinical data of patients undergoing aortic valve replacement in different ages in our hospital were retrospectively analyzed. The etiological characteristics of the patients were analyzed, and their differences in time were compared. Respectively, aortic stenosis, aortic regurgitation, aortic stenosis with insufficiency in the three groups were analyzed, the specific causes include rheumatic, bifacial aorta, degenerative aortic valve, aortic root expansion, infectious heart Endocarditis, rare and not identified and other 6 kinds of etiology. Results: Rheumatic, two-lobe aortic valve, aortic root dilatation and degenerative aortic valve disease were the main etiological types, in which aortic stenosis with rheumatic (43 cases, 59.7%) and two-lobe Seventeen patients (23.6%) had primary, simple aortic regurgitation with root dilatation (38 cases, 43.2%) and rheumatic (70 cases, 88.5%) with aortic valve stenosis the Lord. With the social progress and population aging, the proportion of rheumatic etiology dropped significantly, aortic root aortic closure caused by aortic insufficiency increased significantly, degenerative aortic valve increased, two-leaf aortic valve , Infective endocarditis caused by valve damage is not obvious. CONCLUSION: The changes of aortic valve etiology and their characteristics are instructive in the clinical diagnosis and treatment of aortic valve and the development of medical strategies.