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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。
OBJECTIVE: To investigate the effect of posterior wall aneurysms with severe mitral regurgitation on left ventricular wall thrombosis after myocardial infarction. Methods: A retrospective analysis of 340 patients with myocardial infarction after the formation of aneurysm in patients with clinical data, according to whether severe mitral regurgitation is divided into severe mitral regurgitation group and non-severe mitral regurgitation group, severe mitral In 84 patients with mitral regurgitation, 256 patients with mild or no mitral regurgitation were classified as non-severe mitral regurgitation group. The left atrium diameter, left ventricular end-diastolic diameter, left ventricular end systolic diameter , Interventricular septum and left ventricular posterior wall thickness, left ventricular ejection fraction and incidence of left ventricular wall thrombosis. RESULTS: The results showed that the incidence of mural thrombus in patients with severe mitral regurgitation was significantly lower than that in non-severe mitral regurgitation (11% vs.22%, P <0.05). Left atrial diameter, left ventricular end-diastolic diameter, and left ventricular end-systolic diameter in severe mitral regurgitation group were significantly larger than those in non-severe mitral regurgitation group (all P <0.01). Left ventricular ejection fraction was significantly lower in the severe mitral regurgitation group than in the non-severe mitral regurgitation group. Left ventricular diastolic ventricular septal thickness and posterior wall thickness of the two groups no significant difference. Conclusion: The formation of parietal wall aneurysms with severe mitral regurgitation may reduce the incidence of left ventricular wall thrombosis after myocardial infarction.