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[1]鄭美端,劉建平.房性與室性功能性二尖瓣反流的預(yù)后研究[J].福建醫(yī)藥雜志,2024,46(04):18-22.[doi:10.20148/j.fmj.2024.04.005]
　ZHENG Meiduan,LIU Jianping.Prognostic study on atrial and ventricular functional mitral regurgitation[J].FUJIAN MEDICAL JOURNAL,2024,46(04):18-22.[doi:10.20148/j.fmj.2024.04.005]
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房性與室性功能性二尖瓣反流的預(yù)后研究()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
46
期數(shù):
2024年04期
頁碼:
18-22
欄目:
臨床研究
出版日期:
2024-08-15

文章信息/Info

Title:
Prognostic study on atrial and ventricular functional mitral regurgitation
文章編號(hào):
1002-2600(2024)04-0018-04
作者:
鄭美端; 劉建平
福建省泉州市第一醫(yī)院心臟彩超室,泉州 362000
Author(s):
ZHENG Meiduan; LIU Jianping
Department of Echocardiography,Quanzhou First Hospital,Quanzhou,Fujian 362000,China
關(guān)鍵詞:
二尖瓣反流;  功能性;  預(yù)后
Keywords:
mitral regurgitation;  functional;  prognosis
分類號(hào):
R445.1; R542.5+1
DOI:
10.20148/j.fmj.2024.04.005
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 探討不同類型功能性二尖瓣反流(functional mitral regurgitation,FMR)患者的預(yù)后。方法 納入2020年1月至2022年1月于我院首次住院的3+級和4+級的FMR患者,中位隨訪30個(gè)月,根據(jù)患者的病史和超聲心動(dòng)圖特點(diǎn),分為室性FMR(ventricular functional MR,VFMR)組和房性FMR(atrial functional MR,AFMR)組,收集患者病歷資料和預(yù)后情況,分析不同類型FMR患者的全因死亡率、心衰再入院率及其影響因素。結(jié)果 共有357例患者納入研究,平均年齡65歲,男性230例,女性127例; 其中VFMR組273例、 AFMR組84例。研究的主要終點(diǎn)為全因死亡率、心力衰竭再入院率和復(fù)合終點(diǎn)發(fā)生率(全因死亡率和/或因心衰再次入院)。復(fù)合終點(diǎn)發(fā)生率AFMR組明顯低于VFMR組[HR=0.51,95%CI(0.33,0.79),P<0.05]。伴有房顫的FMR復(fù)合終點(diǎn)的發(fā)生率高于不伴房顫者(VFMR組P<0.01,AFMR組P=0.01)。缺血性和非缺血性VFMR復(fù)合終點(diǎn)發(fā)生率差異無統(tǒng)計(jì)學(xué)意義(P=0.24)。高水平BNP(b-type natriuretic peptide)是VFMR出現(xiàn)心血管事件的獨(dú)立危險(xiǎn)因素,肌酐和左室舒張末內(nèi)徑是AFMR出現(xiàn)心血管事件的獨(dú)立危險(xiǎn)因素。結(jié)論 AFMR預(yù)后明顯好于VFMR,兩者的預(yù)后因素不同。
Abstract:
Objective To investigate the prognosis of patients with different types of functional mitral regurgitation(FMR). Methods The study included patients with grade 3+ and grade 4+ FMR who were admitted to our hospital for the first time between January 2020 to January 2022. The median follow-up period was 30 months. Based on the patients' medical history and echocardiography characteristics,they were categorized into the ventricular FMR(VFMR)group and the atrial FMR(AFMR)group. Medical records and prognosis data were collected and then analyzed to determine the all-cause mortality rate and heart failure readmission rate of patients with different types of FMR and their influencing factors.Results A total of 357 patients were included in the study,with a mean age of 65 years. There were 230 males and 127 females. Among them,there were 273 cases in the VFMR group and 84 cases in the AFMR group. The main endpoints of the study were all-cause mortality,heart failure readmission rate,and the composite endpoint occurrence rate of both.The composite endpoint occurence rate in the AFMR group were significantly lower than those in the VFMR group [HR=0.51,95% CI(0.33,0.79),P<0.05].The occurrence rate of the composite endpoint in FMR patients with atrial fibrillation was higher than that in those without atrial fibrillation(VFMR group P<0.01,AFMR group P=0.01). There was no significant difference in the occurrence rate of the composite endpoint between ischemic and non-ischemic VFMR(P=0.24).Cox regression analysis was used to analyze the main influencing factors of composite endpoints. The prognostic factors for VFMR and AFMR were different. High levels of B-type natriuretic peptide(BNP)were an independent risk factor for cardiovascular events in VFMR,while creatinine and left ventricular end-diastolic diameter were independent risk factors for cardiovascular events in AFMR.Conclusion The prognosis of AFMR is significantly better than that of VFMR,and the prognostic factors differ between the two.

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更新日期/Last Update: 2024-08-15