Int J Cardiol:王建安教授发现严重瓣膜疾病中,二尖瓣反流常见

2016-12-07 卢芳 中国循环杂志

疾病也是与时俱进的,为了更好了解当前严重瓣膜性疾病的患病情况,浙江大学附属第二医院王建安等进行了一项医院为基础的调查。结果表明,严重瓣膜性疾病在人群中并不少见,其发病原因在<65岁和≥65岁人群有所差异,前者多为风湿热引起,后者多为退行性病变;前者更多见原发性二尖瓣反流,而后者继发性二尖瓣反流更为多见。 研究显示,在严重瓣膜性心脏病中,二尖瓣反流最为常见,患病率为0.68%;二尖瓣狭窄患

疾病也是与时俱进的,为了更好了解当前严重瓣膜性疾病的患病情况,浙江大学附属第二医院王建安等进行了一项医院为基础的调查。


结果表明,严重瓣膜性疾病在人群中并不少见,其发病原因在<65岁和≥65岁人群有所差异,前者多为风湿热引起,后者多为退行性病变;前者更多见原发性二尖瓣反流,而后者继发性二尖瓣反流更为多见。

 

研究显示,在严重瓣膜性心脏病中,二尖瓣反流最为常见,患病率为0.68%;二尖瓣狭窄患病率为0.38%,主动脉瓣狭窄患病率为0.28%,主动脉反流患病率为0.27%

 

而且,随着年龄的增长,二尖瓣反流和主动脉瓣狭窄的患病率显著上升,而二尖瓣狭窄却呈明显下降趋势;主动脉反流则与增龄无相关性。

 

此外,整体来看,不同年龄组严重瓣膜性心脏病的分布无性别差异;就主动脉反流而言,在男性更为多见,而二尖瓣狭窄在女性更为多见。

 

值得注意的是,研究显示,有0.67%的人罹患严重主动脉瓣膜病变,但这些患者仅19.3%接受了治疗;此外,共有1.22%的人罹患严重二尖瓣瓣膜病变,但接受治疗者也仅15.5%。而且接受治疗的比例随着增龄而显著增加。

 

研究者指出,虽然该研究提示中国人群严重瓣膜性疾病的患病率较西方国家相对较低,但中国人群基数大,这意味着患者群较为庞大。而且该研究表明绝大多数严重瓣膜性患者并未接受治疗,而且这部分人群随着年龄的增长扩大。

 

此外,就严重瓣膜性心脏病的发病原因来看,研究显示风湿热仍是“重头”:99.2%的严重二尖瓣狭窄由此而起;也是导致<65岁患者主动脉狭窄和主动脉反流的重要病因之一。

 

在严重主动脉狭窄患者中,主动脉钙化是最常见病因,其次是二叶型主动脉瓣畸形,后者在年轻患者中多见。

 

对于≥65岁的主动脉瓣反流患者而言,绝大多数为退行性病变,且随增龄而增加。在严重二尖瓣反流患者中,有60.7%的患者为原发性病变。这些原发性二尖瓣反流患者中,50%由二尖瓣脱垂引起,其次为风湿性疾病。

 

这项研究共纳入2010-2015年前来该院就诊的139496例≥18岁的住院和门诊患者。其中严重瓣膜性心脏病定义为:严重主动脉瓣狭窄,最大射流速度或平均射流速度≥4 m/s;最大跨瓣压(△P)≥40 mmHg;严重二尖瓣狭窄,瓣膜面积≤1.5 cm2;严重二尖瓣反流,≥3/4级;严重主动脉瓣反流,≥3/4级。


原始出处:

Hu P1, Liu XB1, Liang J1, Zhu QF1, Pu CX2, Tang MY3, Wang JA4.A hospital-based survey of patients with severe valvular heart disease in China.Int J Cardiol. 2016 Nov 25. 

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    2016-12-09 wwzzly
  3. 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    2016-12-09 feifers
  4. 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  5. 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    2016-12-08 Oriharaizaya

    呵呵

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1781731, encodeId=f66e1e817310b, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Apr 20 19:20:00 CST 2017, time=2017-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463155, encodeId=377c14631554a, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Fri Dec 09 02:20:00 CST 2016, time=2016-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571580, encodeId=222215e15801b, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Fri Dec 09 02:20:00 CST 2016, time=2016-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583489, encodeId=c29515834890d, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Fri Dec 09 02:20:00 CST 2016, time=2016-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161129, encodeId=9789161129cc, content=呵呵, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9611710563, createdName=Oriharaizaya, createdTime=Thu Dec 08 09:15:45 CST 2016, time=2016-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161015, encodeId=5491161015b6, content=学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Wed Dec 07 20:04:38 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161010, encodeId=428216101022, content=给力的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7a3e1928208, createdName=顾小北大魔王, createdTime=Wed Dec 07 19:14:51 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161000, encodeId=d66c16100048, content=了解。, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160813/IMG57AEDF890F38E4669.jpg, createdBy=56b61935142, createdName=1e0db291m32(暂无匿称), createdTime=Wed Dec 07 18:02:34 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160943, encodeId=0f9b16094331, content=是真的吗?!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Wed Dec 07 13:25:29 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160912, encodeId=de35160912ce, content=二尖瓣反流是瓣膜病变中最常见的, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Wed Dec 07 11:52:41 CST 2016, time=2016-12-07, status=1, ipAttribution=)]
    2016-12-07 susice

    学习了,谢谢!

    0

  7. 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    2016-12-07 顾小北大魔王

    给力的研究

    0

  8. 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    2016-12-07 1e0db291m32(暂无匿称)

    了解。

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1781731, encodeId=f66e1e817310b, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Apr 20 19:20:00 CST 2017, time=2017-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463155, encodeId=377c14631554a, content=<a href='/topic/show?id=cff92389310' target=_blank style='color:#2F92EE;'>#二尖瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23893, encryptionId=cff92389310, topicName=二尖瓣)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fdb26536308, createdName=wwzzly, createdTime=Fri Dec 09 02:20:00 CST 2016, time=2016-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571580, encodeId=222215e15801b, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Fri Dec 09 02:20:00 CST 2016, time=2016-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583489, encodeId=c29515834890d, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Fri Dec 09 02:20:00 CST 2016, time=2016-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161129, encodeId=9789161129cc, content=呵呵, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9611710563, createdName=Oriharaizaya, createdTime=Thu Dec 08 09:15:45 CST 2016, time=2016-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161015, encodeId=5491161015b6, content=学习了,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Wed Dec 07 20:04:38 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161010, encodeId=428216101022, content=给力的研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7a3e1928208, createdName=顾小北大魔王, createdTime=Wed Dec 07 19:14:51 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=161000, encodeId=d66c16100048, content=了解。, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160813/IMG57AEDF890F38E4669.jpg, createdBy=56b61935142, createdName=1e0db291m32(暂无匿称), createdTime=Wed Dec 07 18:02:34 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160943, encodeId=0f9b16094331, content=是真的吗?!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Wed Dec 07 13:25:29 CST 2016, time=2016-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=160912, encodeId=de35160912ce, content=二尖瓣反流是瓣膜病变中最常见的, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLBkyaelI9ia3n9SbuKmBdaY0PqCOzd0nhRUstroXmUmXZ5EBTmibtLEvCCIpyHAqxQXGfZz49ibrwjkg/0, createdBy=39781652829, createdName=雾夜芭蕾, createdTime=Wed Dec 07 11:52:41 CST 2016, time=2016-12-07, status=1, ipAttribution=)]
    2016-12-07 thlabcde

    是真的吗?!

    0

  10. 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    2016-12-07 雾夜芭蕾

    二尖瓣反流是瓣膜病变中最常见的

    0

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