急性心肌梗死延迟冠脉介入对左心功能的影响

Effect of delayed percutaneous coronary intervention on left cardial function with acute myocardial infarction

目的探讨急性心肌梗死患者延迟冠脉介入对心功能的影响。方法选择明确诊断急性前壁心肌梗死的患者,在心肌梗死10～30d内行冠状动脉造影术,造影显示前降支血管残余狭窄≥75%者,根据是否进行冠脉介入治疗分为A组和B组。所有患者在造影前及6个月随访时,分别做超声心动图检查,以心内膜运动和室壁增厚率的变化评价室壁运动。同时测量左室收缩末容积(LVESV)、舒张末容积(LVEDV)和左室射血分数(LVEF)结果PCI组血运重建后,随访时E/A比值及左室射血分数均升高(P<0.001;P<0.01),左室收缩末容积指数缩小(P<0.05),室壁运动积分指数降低(P<0.05),而药物治疗组随访时E/A比值及左室射血分数均降低(P<0.05),左室收缩末容积指数增加(P<0.05),室壁运动积分指数升高(P<0.05)。结论延迟介入治疗对有闭塞性血管病变患者的左心室结构和功能恢复有重要的作用。

Objective To evaluate the effect of delayed percutaneous coronary intervention （PCI） on left cardial function with acute myocardial infarction. Methods Sixty seven patients within 10-30 days after AMIhad accepted cardiac angiogram and were found left descending coronary artery （LAD）stenosis 〉75%. The patients were divided into group A（36 cases） and group B（31 cases）. Patients in group A had revascularization while patients in group B had conserve therapy. Allpatients accepted echocardiogram before randomization and 6 months after, ventricular wall motionventricular wall thick, LVESV, LVEDV, E/A and LVEFwere measured. Results In group A, E/A and LVEF increased significantly （P〈0.O01, P〈0.01 respectively） LVESV and wall motion index decreased significantly （both P〈0.05）. In group B, E/A and LVEF decreased significantly（both P〈0.05）. LVESVand wall motion index increased significantly（both P〈0.05）. Conclusion Delayed PCI is useful for reserve left ventricul structure and function after AMI.