摘要
目的探讨首次急性心肌梗死（AMI）患者左心房容积与左心室充盈模式及预后的关系。方法对165例AMI患者的超声心动图参数进行检测。依据二尖瓣E波减速时间（EDT）和左心室舒张早期血流传播速度（Vp）将165例AMI患者分为正常充盈组（43例）、松弛性减低组（55例）、假性正常化组（35例）、限制性充盈组（32例）。以Cox比例风险模型分析远期存活的风险预测。结果与正常充盈组比较，AMI患者松弛性减低组、假性正常化组、限制性充盈组的左心房容积指数（LAVI）增大（P〈0．05-P〈0．01）。随访12（0—27）个月，22例（13．3％）死亡。死亡组的LAVI与生存组比较，差异有统计学意义（P〈0．01）。Cox模型生存分析显示LAVI为死亡的独立危险因子（相对危险系数为1．093，P=0．001）。结论AMI患者舒张功能障碍及左心室重构是导致AMI患者左心房扩大的主要因素。LAVI可稳定地反映左心室舒张功能障碍持续时间及严重程度，是AMI后死亡的独立预测因子。
Objective To investigate the correlation of left atrial volume index （LAVI） with left ventricular （LV） filling models and prognosis in patients with acute myocardial infaretion （AMI）. Methods One hundred and sixty-five patients with AMI were studied with echocardiography. According to mitral E-wave deceleration time （EDT） and early diastolic flow propagation velocity （Vp）, a total of 165 patients with AMI were divided into normal filling group （43 eases ） , impaired relaxation group （55 cases ） , pseudonormal group （35 cases） and restrictive filling group （32 cases）. Multivariate Cox proportional hazards analysis was performed to identify independent predictors of cardiac death. Results Compared with normal filling group, LAVI was higher in impaired relaxation group, pseudonormal group and restrictive group （P〈0.05 -P〈0.01）. During follow-up of 12 （range 0 -27） months, 22 patients （13.3%） died. Compared with surviving group, LAVI was higher in cardiac death group （P 〈 0. 01 ）. Cox analysis illustrated that LAVI was a powerful predictor of cardiac death （ relative hazard coeffieient = 1. 093, P = 0. 001 ）. Conclusions In AMI patients, LV remodeling and diastolic dysfunction may be related to LAVI, and may be important factors of LA enlargement. Increased LAVI is a pocketful predictor of mortality after AMI, and a more stable indicator,reflecting the duration and severity of LV diastolic dysfunction.
出处
《中华临床医师杂志（电子版）》
CAS
2007年第3期24-27,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
超声心动描记术
多普勒
彩色
心室功能
左
心房功能
左
心肌梗塞
Eehocardiography,Doppler,color
Ventricularfunction,left
Atrial function ,left
Myocardial infarction
