Acar J, Michel P L, Dorent R, Luxereau P, Vahanian A, Cormier B, Veron P
Service de cardiologie, Hôpital Tenon, Paris.
Arch Mal Coeur Vaiss. 1992 Apr;85(4):411-5.
The aim of this study was to analyse the evolution of the aetiologies of operated valvular heart disease over a 20 year period and to assess the consequences. Two thousand five hundred and ninety eight patients who underwent conservative surgery or valve replacement were included. This population was classified according to the date of surgery into 4 groups, each corresponding to a 5 year period. Analysis of these results, especially in the groups operated between 1970 and 1974 and between 1985 and 1989 shows: 1) a change in aetiology: decreased incidence of rheumatic valvular disease (36 versus 61%) and an increased incidence of degenerative lesions (43 versus 23%) (p less than 0.0001); 2) a change in the valvular lesions operated, aortic stenosis has become the commonest operated condition (43 versus 27%) (less than 0.001); 3) an increased age (59 +/- 14 versus 49 +/- 13 years, p less than 0.0001) with a higher proportion of patients over 70 years of age (22 versus 1%, p less than 0.001); 4) a higher incidence of mixed coronary and valvular surgery (11 versus 2%, p less than 0.001).
本研究旨在分析20年间接受手术治疗的心脏瓣膜病病因的演变情况，并评估其后果。纳入了2598例接受保守手术或瓣膜置换的患者。根据手术日期将该人群分为4组，每组对应一个5年时间段。对这些结果的分析，尤其是对1970年至1974年以及1985年至1989年期间接受手术的组分析显示：1）病因变化：风湿性瓣膜病发病率下降（36%对61%），退行性病变发病率上升（43%对23%）（p<0.0001）；2）接受手术的瓣膜病变变化，主动脉狭窄已成为最常见的手术病变（43%对27%）（p<0.001）；3）年龄增加（59±14岁对49±13岁，p<0.0001），70岁以上患者比例更高（22%对1%，p<0.001）；4）冠状动脉和瓣膜联合手术的发生率更高（11%对2%，p<0.001）。
