二尖瓣反流对急性心肌梗死后左心室大小及功能的影响

【目的】探讨急性心肌梗死（acute myocardial infarction，AMI）缺血性二尖瓣反流（mural regurgitation，MR）与左心室大小和功能的关系并分析其对患者预后评估的意义。【方法】2000年3月-2006年2月共182例急性心肌梗死患者，入院后5d内行超声心动图检查，以彩色多普勒定量测定其MR。根据彩超结果分为MR组81例及无MR组101例，分别对两组临床资料、超声心动图指标及预后进行对比分析。【结果】MR组81例患者中轻度反流70例，中、重度反流11例。MR组左心室内径显著高于无MR组（P〈0．05），EF值显著降低（P〈0．05）。MR组30d及1年死亡率均显著高于无MR组（P〈0．05和P〈0．01）。【结论】AMI患者MR的出现是左心室扩张和心功能不全的重要因素，超声心动图证实的MR对AMI患者的预后具有预测价值。

Influence of mitral regurgitation on the size and function of left ventricle in patients with acute myocardial infarction

Objective] To evaluate the prognostic significance and the influence to the left ventricular size and function of mitral renurnitation （MR） detected by echocardionraphy in patients with acute myocardial infarction （AMI） Methods] This study assessed the long-term risk associated with MR detected by color Doppler echocardionraphy within 5 days of admission in 182 patients with AMI from March 2000 to February 2006. The clinic data, echocardionraphic index and prognosis of the patients with MR were compared with the patients without MR. Results] There were 70 cases with mild MR and 11 cases with moderate or severe MR seen in 81 patients of MR group, compared with the no MR group , the mean left ventricular internal diameter was bigger and the EF value was lower in patients in MR group, （both P 〈 0.05）. and 30 days and one-year mortality of the patients with MR were higher than those without MR （ P 〈 0.05 or 0.01 ）. Conclusions] The MR is an important factor indicated the left ventricular dilatation and cardiac insufficiency of the AMI, MR detected by color Doppler echocardionraphy have prognostic value in patients with AMI.