心肌梗死后室壁瘤形成伴严重二尖瓣返流对左室附壁血栓形成的影响

目的:探讨心肌梗死后室壁瘤形成伴严重二尖瓣返流对左室附壁血栓形成的影响。方法: 回顾性分析340例心肌梗死后室壁瘤形成患者的临床资料，根据是否并发严重二尖瓣返流分为严重二尖瓣返流组与非严重二尖瓣返流组，严重二尖瓣返流组84例，二尖瓣返流较轻或无返流256例，归为非严重二尖瓣返流组，比较两组左房直径、左室舒张末期直径、左室收缩末期直径、室间隔及左室后壁厚度、左室射血分数及左室附壁血栓发生率。结果: 分析结果显示，严重二尖瓣返流组的左室附壁血栓发生率明显低于非严重二尖瓣返流组(11% vs. 22%,P<0.05)。严重二尖瓣返流组的左房直径、左室舒张末期直径、左室收缩末期直径均大于非严重二尖瓣返流组（均P<0.01)。严重二尖瓣返流组的左室射血分数低于非严重二尖瓣返流组。左室舒张期室间隔厚度及后壁厚度两组无显著差异。结论: 心肌梗死后室壁瘤形成伴严重二尖瓣返流时可能有降低左室附壁血栓形成的作用。

Effect of severe mitral regurgitation on left ventricular mural thrombus formation in patients with aneurysm after myocardial infarction

AIM: To explore the effect of severe mitral regurgitation(MR) on left ventricular mural thrombus formation in patients with aneurysm after myocardial infarction(MI).METHODS: Clinical data of 340 consecutive patients with left ventricular aneurysm(LVA) after MI were retrospectively analyzed.Patients were divided into two groups according to the degree of mitral regurgitation diagnosed by echocardiography: 84 cases in severe MR group and 256 cases in nonsevere MR group.Mean left atrial(LA),LV end-diastolic an...