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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。
Objective To investigate the correlation between different degrees of mitral regurgitation (MR) and left ventricular ejection fraction (LVEF) in elderly patients (age> 60 years) at 2 years follow-up. Methods A total of 522 senile patients with mild or chronic organic MR were selected and divided into ischemic MR (IMR) group and non-ischemic MR (NIMR) group according to their etiology. The selected patients to establish a detailed medical records, requiring patients to review our hospital every year echocardiography, referral and telephone follow-up. After 2 years of follow-up, the complete data were collected for statistical analysis. Results (1) The level of MR was negatively correlated with the mean LVEF. The mean LVEF of moderate and severe IMR patients was lower than that of NIMR patients with the same degree (P <0.05). (2) After adjusting for age, sex, The levels of LVEF in mild, moderate, and severe MR patients in IMR group were7.7% (1.4-4.1), 2.7% (1.3-4.0), 5.2% respectively, on the basis of multiple factors such as body mass index, diabetes mellitus, (3.5 ~ 6.9), the trend P value was 0.04. The decrease of LVEF in mild, moderate and severe MR patients was 3.2% (1.6-4.8), 3.0% (1.4-4.5), 1.7% 3.9), trend P value = 0.30. Conclusions The larger the degree of MR regurgitation, the lower the mean LVEF, the lower mean LVEF of moderate and severe IMR patients than the same level of NIMR patients, and the stratified management for severe IMR patients will help to improve their LVEF.