扩张型心肌病左心室血栓形成影响因素的超声心动图研究

Echocardiographical study on left ventricular thrombus formation in dilated cardiomyopathy

目的 探讨扩张型心肌病时左心室血栓形成的影响因素 ,及二尖瓣反流对左心室血栓形成的影响。方法 65例扩张型心肌病患者根据有无左室血栓分成A组 (无左室血栓组 )和B组 (左室血栓组 ) ,对两组患者的临床资料及超声心动图进行比较分析。结果 A组 5 7例 ,B组 8例 ,两组患者年龄、性别、临床资料以及凝血象差异均无显著性意义。B组左房内径、左室收缩末内径均较A组明显增大 ,而左室射血分数较A组明显减低。存在二尖瓣反流的患者两组间无明显差别 ,但重度二尖瓣反流只存在于A组患者中。结论 扩张型心肌病时左室血栓的形成与多种因素有关 ,左室射血分数是影响左室血栓形成的最重要促进因素 。

Objective To study the factors in left ventricular thrombus formation in dilated cardiomyopathy,especially the effect of mitral regurgitation on left ventricular thrombus formation in dilated cardiomyopathy.Methods Sixty five patients with dilated cardiomyopathy were devided into two groups according to the left ventricular thrombus presen(A group) or not (B group), the echocardiography of each patient was evaluated and the role of clotting factors in left ventricular thrombus formation was assessed.Results Left ventricular thrombus was not present in 57 patients (group A) and present in 8 patients (group B). Group B had larger left atrial and left ventricular systolic dimensions and decreased left ventricular systolic fraction. Although mitral regurgitation was not significantly different between group A and group B,severe mitral regurgitation was found only in group A patients.Conclusions Among patients with dilated cardiomyopathy, left ventricular ejection fraction is the factor most associated with left ventricular thrombus formation.The presence of severe mitral regurgitation may have a protective role in left ventricular thrombus formation.