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【目的】探讨左心房自发超声显影(SEC)在风湿性二尖瓣狭窄患者诊治中的意义。【方法】回顾性分析本院2012年1月至2013年6月收治的159例风湿性二尖瓣狭窄患者的临床资料,根据患者左心房有无 SEC 分为观察组55例(有 SEC)和对照组104例(无 SEC)。所有患者均经心电图,经胸廓超声心动图和经食管超声心动图检查确诊。比较两组患者房颤发生情况、左心房面积(LAS)、左心房直径(LAD)、二尖瓣的面积(MVA)、舒张期二尖瓣口压差及左心室射血分数(LVEF)等相关指标,并分析其与 SEC 的相关性。【结果】观察组房颤发生率显著高于对照组,MVA 小于对照组,舒张期二尖瓣口压差显著高于对照组,LAD 、LAS 均高于对照组,差异均具有统计学意义(均 P <0.05)。单因素回归分析显示:房颤、MVA 、LAS 、舒张期二尖瓣口压差与 SEC 显著相关(均P <0.05),多因素回归分析显示:MVA 及舒张期二尖瓣口压差与 SEC 独立相关。【结论】左心房 SEC 与 MVA及舒张期二尖瓣口压差密切相关,SEC 检测在风湿性二尖瓣狭窄患者的诊治中有重要意义。“,”Objective] To explore the significance of spontaneous echo contrast (SEC) in rheumatism patients with mitral stenosis (MS) .[Methods] From January 2012 to June 2013 ,a total of 159 cases of symptomatic MS were recruited to undergo transthoracic and transesophageal echocardiography .And they were divided into two groups based on the presence or absence of SEC .[Results] Observation group is significantly higher than the con‐trol group ,mitral valve area (MVA) was less than control group ,diastolic mitral valve opening differential pres‐sure was significantly higher than control group .The values of left atrial diameter (LAD) and left atrial surface (LAS) were higher than those of control group .And the differences were statistically significant ( P < 0 .05) . Single factor regression analysis showed that atrial fibrillation ,MVA ,LAS and diastolic mitral valve opening dif‐ferential pressure were significantly associated with SEC (all P < 0 .05 ) . Multiple factor regression analysis showed that MVA and diastolic mitral valve opening pressure difference were associated with SEC independence .[Conclusion] Left atrial spontaneous echo contrast is closely correlated with MVA and diastolic mitral valve open ‐ing differential pressure .And it is of special significance to develop SEC for patients with severe rheumatic mitral stenosis .