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目的:探讨急性心肌梗死(AMI)患者伴发二尖瓣关闭不全(MR)的临床意义及预后。方法:将2年来我院收治的AMI患者145例分为MR组与no-MR组;根据梗死部位分为前壁AMI组与下壁AMI组,前、下壁各组又根据是否伴发MR分为:前壁MR组与前壁no-MR,下壁MR组与下壁no-MR组4个亚组。观察各组的临床情况与心血管事件。结果:MR组63例,占43.4%,与no-MR组相比,其年龄、左心室射血分数、终点心血管事件及随访期间心血管事件均差异具有统计学意义(P<0.05)。亚组间相比,前壁AMI-MR组与下壁AMI-MR组与相应的no-MR组比较终点心血管事件差异具有统计学意义,且该2组间随访期间临床心血管事件差异具有统计学意义(P<0.05);下壁AMI-MR组与no-MR组2组间的终点心血管事件差异具有统计学意义(P<0.05)。结论:AMI患者伴发MR提示预后不良,AMI患者伴有MR与梗死部位有关,且其部位与预后密切相关。
Objective: To investigate the clinical significance and prognosis of patients with acute myocardial infarction (AMI) complicated with mitral regurgitation (MR). Methods: One hundred and forty-five AMI patients admitted to our hospital in 2 years were divided into MR group and no-MR group. According to infarction site, AMI group and AMI group were divided into two groups. Divided into: the anterior MR group and the front wall no-MR, the next MR group and the lower wall no-MR group 4 subgroups. The clinical status and cardiovascular events in each group were observed. Results: There were 63 cases in MR group, accounting for 43.4%. There was significant difference in age, left ventricular ejection fraction, end point cardiovascular events and follow-up cardiovascular events compared with no-MR group (P <0.05). The difference in end point cardiovascular events between the AMI-MR group and the inferior AMI-MR group compared with the corresponding no-MR group was statistically significant, and the difference in clinical cardiovascular events between the two groups during follow-up was statistically significant (P <0.05). The difference of end point cardiovascular events between AMI-MR group and no-MR group was statistically significant (P <0.05). Conclusion: Patients with AMI accompanied with MR suggest a poor prognosis. Patients with AMI are associated with infarction sites and their location is closely related to prognosis.