南方医科大学学报

南方医科大学学报 ›› 2012, Vol. 32 ›› Issue (10): 1516-.

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老年患者二尖瓣反流水平与左室射血分数相关性的随访研究

曾平，龙梅菁，周颖玲，陈勇驰，张璐，卓胜青，田相亭，杨辉剑，连环，靖林林   

  • 出版日期:2012-10-20 发布日期:2012-10-20

Correlation between mitral regurgitation grading and left ventricular ejection fraction in elderly patients:a follow-up study

  • Online:2012-10-20 Published:2012-10-20

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摘要： 目的研究老年患者（年龄>60岁）不同程度二尖瓣反流（MR）与随访2年后左室射血分数（LVEF）变化的相关性。方法选
取522名具有轻度或以上的慢性器质性MR老年患者，按病因分为缺血性MR（IMR）组和非缺血性MR（NIMR）组。对入选患者
建立详细的医疗档案，要求患者每年到我院复查超声心动图、复诊并电话随访。随访2年后对收集完整的资料进行统计学分
析。结果（1）MR程度与LVEF均值成负相关，中、重度IMR患者LVEF均值均低于相同程度的NIMR患者（P<0.05）；（2）随访2
年后，在调整了年龄、性别、体质量指数、糖尿病、高血压病、房颤等多因素基础上，IMR组轻、中、重度MR患者LVEF降低程度分
别为.7% (1.4~4.1)，2.7% (1.3~4.0)，5.2% (3.5~6.9)，趋势P值=0.04；NIMR组轻度、中度、重度MR患者LVEF降低程度分别为
3.2% (1.6~4.8)，3.0%(1.4~4.5)，1.7%(-0.5~3.9)，趋势P值=0.30。结论MR返流程度越大，LVEF均值越低，中、重度IMR患者
LVEF均值低于相同程度的NIMR患者，针对重度IMR患者的分层管理将有助于改善其LVEF。

Abstract: ObjectiveTo analyze the correlation between mitral regurgitation grading and left ventricular ejection fraction in
elderly patients (>60years of age) in a2-year follow-up. MethodsA total of455patients with the diagnosis of at least mild
mitral regurgitation by echocardiography were divided into ischemic mitral regurgitation (IMR) group and non-ischemic
regurgitation (NIMR) group. The patients were followed up with echocardiography every 6 months and the data were
analyzed at the end of24months.ResultsMitral regurgitation grade was inversely correlated with left ventricular ejection
fraction (LVEF). Patients with moderate and severe IMR had a lower LVEF than those with NIMR (P<0.05). After adjustment
for age, sex, body mass index, high blood pressure, diabetes, atrial fibrillation and cardiomyopathy, the mean LVEF at2years
was lowered by2.7% (1.4%-4.1% ),2.7% (1.3%-4.0% ), and5.2% (3.5%-6.9% ) in mild, moderate and severe IMR patients,
respectively (P<0.04), and by 3.2% (1.6%-4.8% ), and3.0% (1.4%-4.5% ), and1.7% (-0.5%-3.9% ) in mild, moderate and severe
NIMR patients (P=0.30). ConclusionThe mean LVEF in IMR patients is significantly lowered compared to that in NIMR
patients. The grade of mitral regurgitation is inversely correlated with the regurgitation area in IMR patients. Stratified
management might help improve LVEF in severe IMR patients.