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目的利用超声心动图研究二叶主动脉瓣(BAV)患者胸主动脉的形态学特征。方法回顾性分析1991年4月至2006年2月诊断的273例 BAV 患者的超声心动图及临床资料。结果(1)无明显主动脉瓣(AV)病变的 BAV 患者的主动脉瓣环、窦部、窦管结合部、升主动脉较正常对照组明显增宽(P≤0.001);而二者胸降主动脉比较差异无统计学意义(P=0.061)。(2)BAV 患者的AV 排列位置对各级胸主动脉内径无影响(P>0.05)。(3)主动脉瓣环、窦部内径与 AV 最大压力阶差、平均压力阶差呈低度负相关;主动脉瓣环、窦部、窦管结合部内径与 AV 反流程度呈低度正相关。结论 BAV 患者的胸主动脉可发生独立于血流动力学影响之外的扩张。AV 的功能变化对胸主动脉内径影响略有不同。在临床上,主动脉内径可作为手术时机选择的参考指标。
Objective To study the morphological characteristics of thoracic aorta in patients with two-lobe aortic valve (BAV) by echocardiography. Methods The echocardiography and clinical data of 273 BAV patients diagnosed from April 1991 to February 2006 were retrospectively analyzed. Results (1) The aortic rings, sinus, sinus junction and ascending aorta in BAV patients without obvious aortic valve (AV) lesion were significantly wider than those in normal control group (P≤0.001) There was no significant difference in descending aorta (P = 0.061). (2) The location of AV in BAV patients had no effect on the diameter of thoracic aorta at all levels (P> 0.05). (3) The aortic annulus, the diameter of the sinus and the AV maximum pressure gradient, mean pressure gradient showed a low negative correlation; aortic annulus, sinus, sinus junction diameter and AV regurgitation degree was low positive Related. Conclusions Dilatation of the thoracic aorta in patients with BAV can occur independent of hemodynamic effects. The functional changes of AV have a slightly different effect on the internal diameter of the thoracic aorta. Clinically, aortic diameter can be used as a reference for the timing of surgery.