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目的探讨急性心肌梗死二尖瓣返流的机制。方法用彩色多普勒超声对 91例急性首次心梗患者按半定量法测定二尖瓣返流。结果心梗伴二尖瓣返流患者左室容积大、球形度大、下壁室壁异常运动积分高。在前壁梗死患者中有类似表现 ;而下壁梗死患者中 ,返流组下壁室壁异常运动积分高 ,其它指标差异均无显著意义。Logistic逐步回归分析发现左室舒张末期球形度和下壁室壁异常运动积分是二尖瓣返流的独立相关因素。结论左室球形度增大 ,使乳头肌向两侧移位 ,以及乳头肌附近的心室壁梗死或缺血导致的运动障碍是心梗急性期二尖瓣返流的重要机制
Objective To investigate the mechanism of mitral regurgitation in patients with acute myocardial infarction. Methods The color Doppler ultrasound was used to measure the mitral regurgitation in 91 patients with acute first myocardial infarction by semiquantitative method. Results Myocardial infarction with mitral regurgitation had a large left ventricular volume, a large sphericity, and an abnormally high motor wall score. In patients with anterior wall infarction have a similar performance; and inferior wall infarction patients, reflux group wall wall abnormal movement score was high, the other indicators were no significant difference. Logistic stepwise regression analysis showed that left ventricular end-diastolic sphericity and inferior wall motion abnormalities were independent correlates of mitral regurgitation. Conclusions The increase of left ventricular sphericity, displacement of papillary muscles to both sides and ventricular wall infarction near the papillary muscles or ischemic movement disorders are important mechanisms of mitral regurgitation in acute myocardial infarction