功能性二尖瓣反流与慢性心力衰竭预后相关性分析

Relationship between functional mitral regurgitation and prognosis of chronic heart failure

目的观察不同程度功能性二尖瓣反流(mitral regurgitation,MR)对慢性心力衰竭(chronic heart failure,CHF)患者预后的影响。方法回顾分析96例CHF患者超声心动图资料,根据不同程度MR,将患者分为重度(22例)、中度(34例)、轻度反流(40例)3组,根据随访期间患者是否出现主要不良心脏事件将其又分为心脏事件组(36例)和无心脏事件组(60例)。检测患者高敏C反应蛋白(hs-CRP)浓度,并进行临床随访观察。结果重度反流组患者为22.9%,中度反流组为35.4%,轻度反流组为41.7%。MR严重程度与患者左心室收缩舒张功能、左心室内径、左心房内径以及肺动脉压相关(P<0.05)。心脏事件组和无心脏事件组MR的严重程度有显著差异(P<0.05),MR严重程度与患者病死率和再住院率相关(P<0.05)。hs-CRP的浓度随CHF和MR的严重程度增加而明显增加。结论CHF患者常见功能性MR,反流的严重程度与患者预后相关。

Objective To evaluate the influence of functional mitral regurgitation （MR） on prognosis of patients with chronic heart failure. Methods Ninety-six systolic heart failure patients with functional MR were enrolled. The clinical and echocardiographic data, concentration of hs-CRP were analyzed retrospectively. All patients were followed up for 8 ± 4 months. Results Among these patients,MR was severe in 22（22. 9%）,moderate in 34（35.4%） and mild in 40（41.7%）. The severity of MR correlated with severity of systolic dysfunction,internal diameters of left ventricle and left atrium,diastolic dysfunction and pulmonary artery pressure（P〈0.05）. The concentration of hs-CRP was significantly increased with increasing the severity of CHF and MR. The sever sion ity of MR was correlated with fatality rate and re-hospitalization rate （ P〈0.05）. Conclusion Functional MR is common in patients with chronic heart failure. Severity of MR correlates heart function and prognosis of patients with chronic heart failure.