急性心肌梗死早期伴发二尖瓣关闭不全对患者预后影响

Prognosis of mitral regurgitation in patients with acute myocardial infarction

目的:探讨急性心肌梗死(AMI)患者伴发二尖瓣关闭不全(MR)的临床意义及预后。方法:将2年来我院收治的AMI患者145例分为MR组与no-MR组;根据梗死部位分为前壁AMI组与下壁AMI组,前、下壁各组又根据是否伴发MR分为:前壁MR组与前壁no-MR,下壁MR组与下壁no-MR组4个亚组。观察各组的临床情况与心血管事件。结果:MR组63例,占43.4%,与no-MR组相比,其年龄、左心室射血分数、终点心血管事件及随访期间心血管事件均差异具有统计学意义(P<0.05)。亚组间相比,前壁AMI-MR组与下壁AMI-MR组与相应的no-MR组比较终点心血管事件差异具有统计学意义,且该2组间随访期间临床心血管事件差异具有统计学意义(P<0.05);下壁AMI-MR组与no-MR组2组间的终点心血管事件差异具有统计学意义(P<0.05)。结论:AMI患者伴发MR提示预后不良,AMI患者伴有MR与梗死部位有关,且其部位与预后密切相关。

Objective：To investigate the clinical significance and prognosis of mitral regurgitation （MR） in patients with acute myocardial infarction （AMI）.Method：145 patients with AMI admitted in our hospital in two years were divided into two groups ：AMI with MR group and without MR group. According to the spot of myocardial infarction,the AMI group was further divided into four subgroups,anterior wall acute myocardial infarction with MR group,anterior wall acute myocardial infarction without MR group,inferior wall acute myocardial infarction with MR group and inferior wall acute myocardial infarction without MR group. The clinical setting and heart-blood event in all groups were analyzed. Result：Among 145 patients ,MR was found in 63 patients （43.4 %）. The age,left ventricular injection fraction （LVEF）,heart-blood event in endpoint and in follow-up phase in AMI with MR group were much higher than those in AMI without MR group （P〈0.05）. Compared sub-group eachother,in the infarction with MR group ,anterior wall acute myocardial infarction with MR group had higher in heart-blood event in endpoint and in follow-up phase. Conclusion：MR with AMI indicated poor prognosis. MR with AMI patients were closely related to infarction spots. Moreover,the infarction spots of MR with AMI patients were closely related to the prognosis of patients.