摘要
目的:探讨二尖瓣反流(MR)及血浆N末端B型尿钠肽前体(NT-proBNP)与急性心肌梗死(AMI)患者远期预后的相关性。方法:入选195例AMI患者,应用超声检测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,分为中重度MR组(MR组)和无及轻度MR组(非MR组),对其中57例患者进行血浆NT-proBNP检测。随访的中位数时间为523天。观察两组心血管事件的相关因素。结果:AMI患者MR的总发生率为75.95%,中重度55例(29.50%)。MR的发生及程度与高龄、女性、Killip分级、糖尿病及非ST段抬高性心肌梗死等相关。生存分析显示MR是AMI后远期死亡强的危险因素(RR=10.984,P<0.0001)。中重度MR及LVEF 与NT-proBNP显著相关。结论:中重度MR是AMI远期预后的唯一独立预测因素,MR的程度与血浆NT-proBNP水平密切相关,联合检测可能有助于明确患者预后。
Objective： To study the relationship of mitral regurgitation（MR）, N-terminal brain natriuretic peptide and outcomes in patients with acute myocardial infarction （AM1）. Methods： 183 patients with AMI were divided into MR group and non-MR group according to the results of echocardiography. The degree of MR, LVEDD, LVESD, LAD, LVEF, and E/A ratio were recorded. Plasma NT-proBNP was measured in 50 patients. Median term of follow-up was 439 days. The related factors with cardiovascular events （heart failure, re-Ml, re-angina and cardiac death） were analyzed. Results： the prevalence of MR in AMI patients was 73.4%, in which median and severe MR was 23.7%. 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. The survival analysis showed that MR was the only independent predictor for the long- term mortality in AMI patients （P〈0.001）. Median and severe MR was significantly con＇elated with NT-proBNP level. Conclusions： median and severe MR is the only independent predictor for the long-term mortality in AMI patients. The degree of MR is correlated with NT-proBNP, and this might be help to recognize the high risk AMI patients in early time.
出处
《中国医药导刊》
2010年第5期724-725,共2页
Chinese Journal of Medicinal Guide
关键词
二尖瓣反流
急性心肌梗死
心血管事件
N-端脑钠肽前体
Mitral regurgitation
Acute myocardial infarction
Cardiovascular events
N-terminal brain natriuretic peptide
