二尖瓣E/A比值对女性初发急性心肌梗死患者的预后价值  

The Prognostic Value of Mitral E/A Ratio in Female Patients with First Onset Acute Myocardial Infarction

作　　者：李彬[1] 王家莹[2] 毛静远[1] 郑颖[1] 赵志强[1] 王贤良[1] 

机构地区：[1]天津中医药大学第一附属医院 [2]天津中医药大学

出　　处：《中西医结合心脑血管病杂志》2013年第6期645-648,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项基金资助(No.JDZX2012140);教育部"创新团队发展计划"-中医药防治心血管疾病研究(No.IRT1276)

摘　　要：目的探讨超声心动图中二尖瓣E/A比值对女性初发急性心肌梗死患者的预后价值。方法回顾性分析2009年1月—2012年12月于我院诊断为初发急性心肌梗死的75例女性患者的临床资料,以E/A比值为1作为截断点分为两组:E/A<1组39例;1≤E/A<2组36例,比较两组患者的临床资料、超声心动图指标及预后。以住院期间及出院至2012年12月内发生心血管死亡事件为研究终点。采用卡方检验或t检验进行基线资料的均衡性分析。采用Spearman秩相关、K-M法和Log-rank检验分别分析左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、二尖瓣反流长度、二尖瓣反流宽度、E/A比值与预后的相关性及相关参数不同组间生存率的比较。如提示存在相关性,采用工作特征曲线(ROC曲线)分析其对预后的预测价值。结果 75例女性初发急性心肌梗死患者中,E/A<1组死亡率显著高于1≤E/A<2组,两组差异有统计学意义。E/A比值对预后(是否死亡)的判定灵敏度93.3%,特异度75.6%,阳性预测值71.8%,阴性预测值94.4%。结论女性初发急性心肌梗死患者早期二尖瓣E/A比值具有更好的预后评估价值。Objective To analyze the prognosis value of mitral E/A ratio in female patients （pts） with first onset acute myocardial infarction. Methods Seventy - five female pts with acute myocardial infarction were reviewed. The prognostic information was recor- ded according to the follow- up by telephone and the observation in hospital. According to the difference of ratio of E/A,the pts were divided into two groups：E/A〈1（39 cases） and 1≤E/A〈2（36 cases）. Chi- square was used to check the baseline characteristics. Spearman correlation analysis,Kaplan- Meier survival analysis and log- rank analysis were used to examine the correlation between left ventricular ejection fraction （I.VEF）, left ventricular end- diastolic diameter （LVEDD）, mitral valve regurgitation in length and in width,and E/A ratio and prognosis. If correlation were proven, receiver operating characteristic（ROC curve） was used to further analyze the degree of prognostic value. Results Among the 75 pts suffered from the first myocardial infarction,the mortality in E/A〈1 group was higher than that in 1≤E/A〈2 group with statistical significance. The sensitivity of E/A predicting mortality was 93.3%, the specificity was 75. 6%, the positive prognostic value was 71. 8%, and the negative prognostic value was 94. 4%. Conclusion Compared with other data of echocardiography, E/A might be a efficient index to predict the prognosis of female pts with acute myo- cardial infarction.

关 键 词：急性心肌梗死 女性 超声心动图 

分 类 号：R542.22[医药卫生—心血管疾病]