急性心肌梗塞早期静脉溶栓治疗对左室结构及功能的影响

Evaluation of Impacts of Early Intravenous Thrombolytic Therapy on the Left Ventricular Structure and Function after Acute Myocardial Infarction

目的：观察急性心肌梗塞后左室结构及功能的变化和早期溶栓治疗的影响。方法：对25例急性心肌梗塞病人分别进行了99mTC-MIBI心肌断层显像及多普勒超声心动图检查，其中溶栓再通组15例．未溶栓组10例。结果：心肌断层显像结果显示：溶栓组积分由溶栓前9．4±3．0分降至3．5±2．8分（P＜0．01），而未溶栓组变化不大；超声心动图结果显示：未溶栓组LEDVI、LESVI分别由58．4±5．6增高至68．9±6．1ml／m2（P＜0．05）。由33．8±6．5增高至41．0±4．6ml／m2（P＜0．05s，而溶性组无明显差异。EF值在早期两组均无统计学呈异．12周时溶栓组由48．1±1．3增高至51．2±1．3％（P＜0．05），而未溶栓组变化不大。结论：心肌梗塞后左室结构及功能均有不同程度改变．而早期溶栓治疗能明显改善梗塞部位血液供应，防止心室重构，提高心室功能。

Objective To observe left ventricular structure and function. evaluate the impacts of early thrombolytic therapy on the left ventricular structure and funchion after acute myocardial infarction(AMI). Methods 25 patients with AMI were observed using 99mTC - MIBI rest myocardial tomography imaging and Doppler Echocardiography.Results The findings showed that mean scores in thrombolytic group de- creased from 9. 4 ± 3. 0 before thrombolytic therapy to 3. 5 t±2. 8(P<0.01); mean scores in non- throm- bolytic group had no significant difference. LEDVI、 LESVI in non - thrombolytic group increased respec- tively from 58. 4±5. 6 to 68. 9 ±6.1ml/m2 (P <0.05)in 12 weeks; EF in non - thrombolytic group had no significant difference. Conclusion Left ventricular structure and function may change after AMI. Early thrombolytic therapy can increase blood flow of myocardial infarction area, prevent left ventricular remodel- ing, and improve cardiac function.