2025 年第 4 期 第 20 卷

退行性二尖瓣反流患者的临床特征和性别差异

Clinical characteristics and gender differences in patients with degenerative mitral regurgitation

作者：李冰1蔡雪敏1薛佳1姚艳1韩建成2

英文作者：Li Bing1 Cai Xuemin1 Xue Jia1 Yao Yan1 Han Jiancheng2

单位：1首都医科大学附属北京安贞医院心内科，北京100029；2首都医科大学附属北京安贞医院心脏超声医学中心，北京100029

英文单位：1Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Echocardiography Medical Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：  退行性二尖瓣反流；二尖瓣修复术；性别差异

英文关键词：Degenerativemitralregurgitation;Mitralvalverepair;Genderdifference

• 摘要：

• 目的 探讨行二尖瓣修复术的退行性二尖瓣反流患者的临床特征和性别差异。方法 连续入选2018年1月1日至2022年12月31日在首都医科大学附属北京安贞医院行二尖瓣修复术的退行性二尖瓣反流患者639例。按照性别分组，比较2组临床特征及超声心动图指标差异。结果 在所有入选的639例患者中,女性共195例(30.5%)。与男性相比,女性患者术前年龄较大［58(47,66)岁比54(45,62)岁］，B型脑钠肽及D-二聚体水平更高(均P＜0.05)。不同性别患者瓣膜脱垂部位及腱索断裂情况差异均无统计学意义（均P＞0.05）。女性患者左心房前后径、右心房内径、左心室舒张末期内径、左心室收缩末期内径均小于男性(均P＜0.001),但用体表面积校正后上述影像学指标女性均大于男性,其中校正后左心室舒张末期内径及校正后左心室收缩末期内径差异均有统计学意义(均P＜0.001)。结论 对于女性退行性二尖瓣反流患者，未经体表面积校正的超声指标可能低估瓣膜反流致心脏代偿严重程度。

• Objective To investigate the clinical characteristics and gender differences in patients with degenerative mitral regurgitation undergoing mitral valve repair. Methods A total of 639 consecutive patients with degenerative mitral regurgitation who underwent mitral valve repair in Beijing Anzhen Hospital, Capital Medical University from January 1, 2018 to December 31, 2022 were enrolled. The patients were grouped according to gender, and the differences in clinical characteristics and echocardiographic parameters between the two groups were compared. Results Of the 639 enrolled patients, 195 (30.5%) were female. Compared with male patients, female patients were older ［58(47,66)years vs 54(45,62)years］ and had higher levels of brain natriuretic peptide and D-dimer before surgery (all P＜0.05). There was no significant difference in the location of valve prolapse and chordae tendineae rupture between male and female patients （all P＞0.05）. The left atrial anteroposterior diameter, right atrial diameter, left ventricular end-diastolic diameter and left ventricular end-systolic diameter of female patients were smaller than those of male patients (all P＜0.001). However, after adjusting for body surface area, the above imaging parameters were larger in female than in male, and the corrected left ventricular end-diastolic diameter and corrected left ventricular end-systolic diameter were significantly different (all P＜0.001). Conclusion For female patients with degenerative mitral regurgitation, ultrasound parameters without body surface area correction may underestimate the severity of cardiac compensation caused by valvular regurgitation.