缺血性心肌病发生缺血性二尖瓣反流的危险因素  

Risk factors of ischemic mitral regurgitation in ischemic cardiomyopathy

作　　者：胡文姝 聂淑婷 邵袁缘 李心怡 周畅[1] HU Wenshu;NIE Shuting;SHAO Yuanyuan;LI Xinyi;ZHOU Chang(Department of Ultrasound,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院超声科,湖北宜昌443003

出　　处：《中国医学影像技术》2024年第7期1009-1014,共6页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察缺血性心肌病发生缺血性二尖瓣反流(IMR)的危险因素。方法回顾性选择143例缺血性心肌病患者,根据有无IMR将其分为IMR+组(n=68)及IMR-组(n=75);另以50名健康志愿者为对照组;比较组间一般资料、左心室常规超声参数、三维斑点追踪成像(3D-STI)参数及二尖瓣结构功能参数,以logistic回归分析筛选发生IMR的危险因素。结果IMR+组与IMR-组左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室整体纵向应变(GLS)、整体扭转角度峰值(Twist)、帐篷容积(VTent)及小叶总面积(TLA)/瓣环面积(AA)差异均有统计学意义(P均<0.05);GLS减小、Twist降低及VTent增大均为缺血性心肌病发生IMR的独立危险因素(P均<0.05)。结论GLS减小、Twist降低及VTent增大为缺血性心肌病发生IMR的危险因素。Objective To observe the risk factors of ischemic mitral regurgitation(IMR)in ischemic cardiomyopathy.Methods Totally 143 patients with ischemic cardiomyopathy were retrospectively enrolled and divided into IMR+group(n=68)or IMR-group(n=75)based on IMR,while 50 healthy volunteers were taken as controls(control group).The general information,conventional ultrasonic parameters of left ventricle,three-dimensional speckle tracking imaging(3D-STI)parameters as well as mitral valve structural and functional parameters were compared among groups,and the risk factors of IMR were screened with logistic regression analysis.Results Significant differences of left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular global longitudinal strain(LVGLS),the peak systolic twist(Twist),tenting volume(VTent)and total leaflet area(TLA)/annulus area(AA)were found between IMR+group and IMR-group(all P<0.05).Decreased LVGLS,decreased Twist and increased VTent were all independent risk factors of IMR in ischemic cardiomyopathy(all P<0.05).Conclusion Decreased LVGLS,decreased Twist and increased VTent were independent risk factors of IMR in ischemic cardiomyopathy.

关 键 词：心肌病 二尖瓣闭锁不全 心室功能 左 超声心动描记术 

分 类 号：R542.2[医药卫生—心血管疾病] R445.1[医药卫生—内科学]