黄青霞,位晨晨,王汸,肖丽,王敏,王玲娟

• 1:南京医科大学姑苏学院南京医科大学附属苏州医院苏州市立医院心血管病中心
• 2:南京医科大学姑苏学院南京医科大学附属苏州医院苏州市立医院超声科

摘要(Abstract)：

目的:探讨四叶式三尖瓣(quadricuspid tricuspid valve, QTV)的超声心动图影像、临床表现及鉴别诊断。方法:回顾性分析我院超声心动图诊断为四叶式三尖瓣患者35例，统计并分析患者症状、体征和超声影像等资料，归纳四叶式三尖瓣的超声图像的共同特征，并由此对三尖瓣反流程度进行鉴别诊断。结果:(1)共纳入35例QTV患者，男性22例，女性13例，年龄范围35～95岁，平均年龄(74.4±13.7)岁。临床症状和体征方面，胸闷患者29例(82.9%)、心悸27例(77.1%)、乏力10例(28.6%)、腹胀6例(17.1%)、呼吸困难9例(25.7%)、下肢水肿22例(62.9%)。(2)QTV患者超声心动图表现为三尖瓣开放呈四叶“花瓣”状，收缩期三尖瓣关闭线呈“十”字征，反流束主要来自关闭线缝隙处或瓣叶交界区，所有患者反流程度均≥3+,常合并右房扩大、右室扩大、右室收缩功能减低、下腔静脉增宽和心包积液等次要特征。结论:超声心动图对QTV患者的诊断及随访具有重要价值，能够显示三尖瓣启闭的形态、是否合并其他瓣膜疾病，能够评估心腔的大小、瓣膜反流的程度及右心容量负荷，为临床用药及进一步介入或手术治疗提供重要依据。

关键词(KeyWords)： 四叶式三尖瓣;反流;超声心动图

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 黄青霞,位晨晨,王汸,肖丽,王敏,王玲娟

DOI: 10.13201/j.issn.1001-1439.2026.10.008

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