老年射血期收缩期杂音患者的多普勒超声心动图检查
Doppler echocardiography in elderly patients with ejection systolic murmurs.
作者信息
McKillop G M, Stewart D A, Burns J M, Ballantyne D
机构信息
Department of Medicine, Victoria Infirmary, Glasgow, UK.
出版信息
Postgrad Med J. 1991 Dec;67(794):1059-61. doi: 10.1136/pgmj.67.794.1059.
Thirty-nine elderly patients, mean age 77 years (range 65 to 96), with ejection systolic murmurs were studied to evaluate the functional significance of these murmurs. Subjects were evaluated clinically, by 2-D echocardiography, and by a full Doppler echocardiography study. Good quality Doppler signals were obtained in 35 subjects. Mitral regurgitation was found to be the only significant valvular lesion in 6 patients (17%). Doppler gradients in systole across the aortic valve were less than 30 mmHg in 28 subjects (80%) and were considered not significant. Gradients of greater than 30 mmHg representing significant aortic stenosis were found in 7 subjects (20%). The clinical sensitivity in detecting significant aortic stenosis was 44% and specificity was 81%. Doppler evidence of significant aortic stenosis was found in a substantial proportion of these elderly subjects. Neither clinical assessment nor 2-D echocardiography can be relied on to exclude this condition.
对39例平均年龄77岁（范围65至96岁）有射血期收缩期杂音的老年患者进行研究，以评估这些杂音的功能意义。通过临床检查、二维超声心动图以及完整的多普勒超声心动图研究对受试者进行评估。35例受试者获得了高质量的多普勒信号。发现二尖瓣反流是6例患者（17%）唯一的重要瓣膜病变。28例受试者（80%）主动脉瓣收缩期多普勒压差小于30 mmHg，被认为无显著意义。7例受试者（20%）发现压差大于30 mmHg，提示存在显著的主动脉瓣狭窄。检测显著主动脉瓣狭窄的临床敏感性为44%，特异性为81%。在这些老年受试者中，相当一部分存在显著主动脉瓣狭窄的多普勒证据。临床评估和二维超声心动图均不能可靠地排除这种情况。
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