【摘要】 目的探讨风湿性二尖瓣狭窄(MS)患者并发中度以上三尖瓣反流(TR)的影响因素。方法测量62例MS合并TR患者的右心常规超声指标,其中43例患者并发房颤(AF)。QTVI状态下测量右心室游离壁近瓣环处心肌收缩期峰值速度(Vs)。结果Logistic回归分析显示,TD/BSA(OR=1.705,P=0.01)、PASP(OR=1.062,P=0.034)、AF(OR=5.084,P=0.05)是中度以上TR发生的独立危险因子。ROC曲线特征显示TD/BSA>18.5mm/m2预测中度以上TR的敏感性为92%、特异性为80%。结论TD/BSA、PASP、AF是MS患者并发中度以上TR的独立危险因素;TD/BSA>18.5mm/m2可以作为预测中度以上TR发生的敏感性指标。更多还原

【Abstract】 Objective To explore the risk and protective factors for occurrence of moderate or severe tricuspid regurgitation(TR) secondary to rheumatic mitral stenosis(MS).Methods Right ventricular indices in 62 TR patients with MS were analyzed.Fourty-three patients had intercurrent atrial fibrillation(AF).Some traditional ultrasonic parameters of right heart were measured.The peak systolic velocity(Vs) on the annular level of RV free wall was measured by quantitative tissue velocity imaging(QTVI).Results Multivariate logistic regression analysis showed that independent risk factors on moderate or severe TR were TD/BSA(TD,Tricuspid annular end diastoic diameter,OR=1.705,P=0.01),pulmonary systolic pressure,PASP(OR=1.062,P=0.034) and AF(OR=5.084,P=0.05).The optimal operating cut-of was point determined at TD/BSA>18.5 mm/m2 by ROC curve.The sensitivity and specificity were 92% and 80% respectively.The occurrence of moderate or severe TR was estimated by TD/BSA>18.5 mm/m~2.Conclusions TD/BSA,PASP and AF may be the independant risk foctors for promoting the occurance of moderate or severe TR.It is sensible to assess the occurrence of moderate or severe TR by TD/BSA>18.5 mm/m~2.更多还原