特发性二尖瓣腱索断裂的相关危险因素探讨

Exploration of the related risk factors of idiopathic mitral chordae tendineae ruptured

目的:通过回顾性分析二尖瓣腱索断裂(MCTR)的超声心动图和临床特征,探讨影响特发性MCTR发生的相关危险因素。方法:收集225例经手术病理证实的MCTR患者,根据病因分为2组:无明确病因且经手术病理证实的特发性MCTR组150例(66.7%);经手术病理证实为二尖瓣脱垂、感染性心内膜炎、风湿性心脏病等其他疾病引起的继发性MCTR组75例(33.3%)。采用单因素分析和多因素Logistic回归分析比较2组的超声心动图和临床特征。结果:单因素分析发现,2组年龄、高血压、冠状动脉硬化性心脏病(冠心病)发病比例、室间隔厚度、左室后壁厚度差异均有统计学意义(均P<0.05)。多因素Logistic回归分析发现,年龄、高血压、冠心病、室间隔厚度、左室后壁厚度是特发性MCTR发生的相关危险因素(OR值分别是3.06、4.93、2.78、4.51、3.57)。结论:年龄、高血压、冠心病是特发性MCTR的相对危险因素;而在超声心动图参数中,左室后壁厚度增加是独立的预测因子。

Objective:To explore the related risk factors of idiopathic mitral chordae tendineae ruptured(MCTR)by retrospectively analysis of the echocardiography and clinical features of this disease.Methods:A total of 225 patients diagnosed with MCTR by surgical pathology were included and divided into two groups according to the disease cause.150 cases(66.7%)with no clear etiology but surgical pathology proven idiopathic MCTR were included in Group A,and 75 cases(33.3%)confirmed secondary MCTR from mitral valve prolapse,infectious endocarditis,rheumatic heart disease and other diseases in Group B.Echocardiography and clinical features were analyzed by single-factor analysis and multi-factor Logistic regression.Results:Single-factor analysis showed that age,hypertension,incidence ratio of coronary heart disease,interventricular septal thickness,and left ventricular posterior wall thickness had statistical differences between the two groups(all P<0.05).Multi-factor Logistic regression analysis showed that those were related risk factors of idiopathic MCTR(OR of 3.06,4.93,2.78,4.51,3.57,respectively).Conclusions:Age,hypertension,coronary heart disease are the related risk factors of idiopathic MCTR,and the increase of left ventricular posterior wall thickness is an independent predictor.