乳头肌功能在缺血性二尖瓣反流机制中作用的研究

目的探讨乳头肌功能在缺血性二尖瓣反流机制中的作用。方法使用超声心动图检测下壁心肌梗死患者41例,按球形度分为两组,第一组球形度基本正常,第二组球形度增大。评价二尖瓣反流程度及左室、二尖瓣装置重构情况及与乳头肌收缩功能的关系。结果第二组较第一组左室和二尖瓣装置重构的程度更大,后乳头肌面积变化率和全组患者的反流程度不相关但却和第二组相关,存在乳头肌功能越好,反流越重的趋势,但多元逐步回归分析结果表明后乳头肌面积变化率不是反流的主要决定因素。结论乳头肌功能障碍并非缺血性二尖瓣反流是主要原因,在某些情况其反而可能会减轻反流。

Influence of papillary muscle function on ischemic mitral regurgitation

Objective To investigate the influence of papillary muscle function on IMR. Methods Forty-one patients with inferior MI which were divided into two groups according the sphericity index were detected by echocardiography, and the relation among the degree of mitral regurgitation, left ventricle and mitral apparatus remodeling and the posterior papillary muscle (PPM) function were assessed. Results Left ventricle and mitral apparatus remodeling were more severe in group two than that in group one. PPM function was correlated with the degree of regurgitation in group two but not with total group. Multivariate analysis based on stepwise multiple linear regression showed that PPM function was not the major determinants of MR. Conclusion Papillary muscle dysfunction was not the main cause of IMR. In an given condition it can relieve the degree of IMR.