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目的探讨二叶主动脉瓣不同融合类型与主动脉扩张的相关性。方法选取35例二叶主动脉瓣畸形患者作为病例组,分析其二维超声特点及形态学特点对主动脉疾病的影响;另选同期35例经胸超声心动图诊断主动脉瓣均正常三叶瓣者为对照组,比较两组瓦氏窦、窦管连接部、升主动脉近端升主动脉内径。结果 35例二叶主动脉瓣中“”关闭线20例,其中5例在一大瓣中央可见回声增强的线性嵴,“/”关闭线9例,“—”关闭线3例,“|”关闭线3例。BAV较多呈右冠瓣与左冠瓣融合型,较少呈右冠瓣与无冠瓣融合型,罕见瓣叶对称型。病例组患者依据升主动脉内径不同分为两组,MPG<20 mm Hg(1 mm Hg=0.133 kPa),即主动脉瓣功能正常的15例BAV患者作为病例组Ⅰ,其余20例作为病例组Ⅱ。病例组Ⅱ患者瓦氏窦、窦管连接部、升主动脉近端升主动脉内径分别为(34.68±0.36)、(33.53±0.36)、(39.38±0.37)mm,均大于对照组的(29.46±0.12)、(26.78±0.35)、(27.50±0.62)mm和病例组Ⅰ的(28.25±0.36)、(26.14±0.32)、(27.36±0.45)mm,差异具有统计学意义(P<0.05)。结论超声心动图评价二叶主动脉瓣融合类型与主动脉扩张关系,有助于对主动脉扩张性病变的预期及判断。
Objective To explore the correlation between different fusion types of aortic valve of two lobes and aortic dilatation. Methods A total of 35 patients with two-lobe aortic valve malformations were selected as the case group, and the effects of two-dimensional ultrasound features and morphological features on aortic diseases were analyzed. Thirty-five cases of transthoracic echocardiography Flap for the control group, compared two groups of Valsalva sinus, sinus junction, proximal ascending aorta ascending aorta diameter. Results In 35 cases of two - lobe aortic valve, 20 cases were closed with “” closing line, of which 5 cases showed echogenic linear ridge in the center of a large flap, 9 cases of “” Close line 3 cases, “| ” off line 3 cases. BAV was more likely to be a fusion of the right coronary and left coronary arteries, with less fusion of the right and left coronary arteries and rare symmetry of the valve leaflets. Patients in the case group were divided into two groups according to the diameter of the ascending aorta: MPG <20 mm Hg (1 mm Hg = 0.133 kPa), that is, 15 cases with normal aortic valve function were treated as case group Ⅰ, and 20 cases were treated as case group II. The diameter of the ascending aorta of the WAs, the sinus junction and the proximal ascending aorta were (34.68 ± 0.36), (33.53 ± 0.36) and (39.38 ± 0.37) mm in case group Ⅱ, which were significantly higher than those in control group (29.46 ± 0.12, 26.78 ± 0.35, 27.50 ± 0.62 and 28.25 ± 0.36, 26.14 ± 0.32 and 27.36 ± 0.45 mm respectively in case group Ⅰ (P0.05) . Conclusion The echocardiographic evaluation of the relationship between the two aortic valve fusion type and aortic dilatation is helpful to predict and judge aortic dilatation.