冠心病合并缺血性二尖瓣返流对预后的影响

目的：探讨冠心病合并缺血性二尖瓣返流(MR)对患者预后的影响。方法收集2008年1月至2010年12月我院收治的冠状动脉粥样硬化性心脏病患者110例，其中55例伴有MR者设为观察组，55例不伴有MR者设为对照组，比较两组患者5年内的跟踪检查结果。结果观察组患者的急性心肌梗死(MI)率为27.27%(15/55)、再次MI率为14.55%(8/55)、心力衰竭(HF)率为67.27%(37/55)、猝死发生率为7.27%(4/55)，均明显高于对照组的12.73%(7/55)、7.27%(4/55)、38.18%(21/55)、3.64%(2/55)，且差异均具有统计学意义(P<0.05)；观察组患者的室性早搏率为29.09%(16/55)、房性早搏率为27.27%(15/55)、心房纤颤率为20.00%(11/55)、窦性心动过缓率为23.64%(13/55)、总发生率为100.00%，均明显高于对照组的20.00%(11/55)、16.36%(9/55)、14.55%(8/55)、14.55%(8/55)、64.45%(36/55)，且差异均具有统计学意义(P<0.05)；轻度MR与中度MR、重度MR相比，急性心肌梗死、再次MI、HF、猝死和心率失常发生率均低于后两者，且差异均具有统计学意义(P<0.05)；而中度MR患者的急性心肌梗死、再次MI、心力衰竭(HF)、猝死和心率失常发生率均低于重度MR组患者，且差异均具有统计学意义(P<0.05)。结论合并缺血性二尖瓣返流会提高冠心病的心血管事件发生率，并影响其预后。

Effect of coronary heart disease combined with ischemic mitral regurgitation on prognosis

Objective To study the effect of coronary heart disease (CHD) combined with ischemic mitral re-gurgitation (MR) on prognosis. Methods A total of 110 patients with CHD admitted in our hospital from January 2008 to December 2010 were selected, including 55 patients with MR (the observation group) and 55 patients without MR (the control group). The results of follow-up (five years) were compared. Results The incidence of acute myocardial in-farction (MI), the recurrence rate of MI, heart failure (HF) rate, incidence of sudden death in the observation group were 27.27%(15/55), 14.55%(8/55), 67.27%(37/55), 7.27%(4/55), which were significantly higher than those in the control group of 12.73%(7/55), 7.27%(4/55), 38.18%(21/55), 3.64%(2/55) (P<0.05). The ventricular premature beat rate, atri-al premature beat rate, atrial fibrillation rate, sinus bradycadia rate, the total incidence rate in the observation group were 29.09%(16/55), 27.27%(15/55), 20.00%(11/55), 23.64%(13/55), 100.00%, respectively, which were significantly high-er than those in the control group of 20.00%(11/55), 16.36%(9/55), 14.55%(8/55), 14.55%(8/55), 64.45%(36/55) (P<0.05). Compared with moderate MR and severe MR, the incidence of MI, recurrence rate of MI, HF rate, incidence of sudden death and arrhythmia of mild MR were significantly lower (P<0.05), and these indexes of moderate MR were sig-nificantly lower than those of severe MR (P<0.05). Conclusion Patients with coronary heart disease combined with ischemic MR has significantly higher incidence of cardiovascular events than that of patients without MR, and MR ex-erts an effect on the prognosis of the disease.