左心室收缩功能对急性冠状动脉综合征患者经皮冠状动脉介入治疗临床转归的影响

Prognostic significance of left ventricular systolic function in acute coronary syndrome patients treated with PCI

目的探讨左心室射血分数减低的急性冠状动脉综合征患者进行经皮冠状动脉介入(PCI)治疗后的临床转归。方法110例急性冠状动脉综合征患者分为左心室射血分数正常(NEF)组和射血分数减低(DEF)组。NEF组共61例患者,男47例,女14例;DEF组共49例患者,男42例,女7例。记录PCI术后患者的重要心血管事件(包括心源性死亡、再次非致命性心肌梗死、再次心绞痛和心功能不全)。结果经过6～54个月随访发现,同NEF组相比,DEF组中术前急性广泛前壁心肌梗死多见,左心室收缩和舒张末期内径较大,高密度脂蛋白(HDL)胆固醇较低,差异有统计学意义。但二组间重要心血管事件发生率差异无统计学意义。结论对于左心室收缩功能减低的急性冠状动脉综合征患者经PCI和积极药物治疗后,近中期临床预后接近左心室收缩功能正常的患者。

Objective To determine clinical outcomes of acute coronary syndrome （ACS） patients with decreased left ventricular function after percutaneous coronary intervention （PCI） . Methods 110 ACS patients were divided into two groups： normal left ventricular ejection fraction （NEF） group （n=61, male/female： 47/14） and decreased left ventricular ejection fraction （DEF） group （n=49, male/female： 42/7）. Incidence of major adverse cardiovascular events （MACE, including cardiac death, recurrent non-fatal myocardial infarction, recurrent angina and chronic heart failure） was recorded. Results During 6 to 54 months follow-up, there was no significant difference between the two groups in incidence of MACE （P〉0.05）, although there were more patients with large area anterior infarction and enlarged left ventricle in the DEF group （P〈0.05）. Conclusion ACS patients with decreased left ventricular function could obtain similar clinical outcomes as patients with normal left ventricular function after PCI and aggressive medical therapy.