摘要
目的:探讨二尖瓣返流(MR)与急性心肌梗死(AMI)患者远期预后的关系。方法:入选143例AMI患者,平均入院5天内行超声心动图检查,分为MR组和非MR组,检测MR的程度、左室舒张期末内径(LVEDD)、左室收缩期末内径(LVESD)、左房内径(LAD)、左室射血分数(LVEF)、E/A比值;随访的中位数时间为439天,观察两组心力衰竭、再发心肌梗死(MI)、再发心绞痛、心因性死亡等心血管事件的发生率与MR的相关性。结果:AMI患者MR的发生率为73.4%,其中轻度62例(43.3%),中度34例(23.7%),重度9例(6.2%)。MR的发生及程度与高龄、女性、Killip分级、舒张压、心率、心力衰竭史、糖尿病、非ST段抬高性MI相关。MR与AMI后心血管事件显著相关。生存分析显示MR是AMI后远期死亡的唯一独立危险因素(P<0.001),中重度MR患者住院期间和远期死亡率显著高于轻度MR组及非MR组。结论: MR是AMI远期预后的唯一独立预测因素。
Objective： To study the relationship of mitral regurgitation （MR） and outcomes in patients with acute myocardial infarction （AMI）. Methods： 143 patients with AMI were divided into MR group and non-MR group according to the results of echocardiography. The degree of MR, LVEI）D, LVESD, LAD, LVEF, and E/A ratio were recorded. Median term of follow-up was 439 days. The relationship of cardiovascular events （heart failure, re-M1, re-angina and cardiac death） and MR were analyzed. Results：The prevalence of MR in AMI patients was 73.4%, in which mild, median and severe MR were 43.3%. 23.7% and 6.2% respectively. The prevalence and degree of MR were significantly correlated with advanced age, feminine. Killip grading, diastolic blood pressure, heart rate. history of heart failure, diabetes and NSTEMI. MR was significantly con＇elated with cardiovascular events in AMI patients. The survival analysis showed that MR was the only independent predictor for the long-term mortality in AMI patients （P〈0.001）. Conclusions： Median and severe MR was the only independent predictor for the long-term mortality in AM1 patients. This might be help to recognize the high risk AMI patients in early time.
出处
《中国医药导刊》
2008年第9期1314-1316,共3页
Chinese Journal of Medicinal Guide
关键词
二尖瓣返流
急性心肌梗死
心血管事件
Mitral regurgitation, Acute myocardial infarction, Cardiovascular events
