超声心动图对PCI术后ST段抬高急性冠脉综合征左心室损害恢复程度的评价

The Evaluation on Recovery Extent of Left Ventricular Damage in ST-segment Elevated Acute Coronary Syndromes after PCI by Echocardiography

目的应用超声心动图量化评价经皮冠状动脉介入(PCI)术后ST段抬高急性冠脉综合征(STEACS)患者左心室结构和收缩功能损害的恢复程度。方法选择经冠状动脉造影(CAG)证实存在冠状动脉狭窄或闭塞并接受PCI术的STEACS患者20例,比较术后与术前超声心动图指标及超声征象的变化,指标包括室间隔(IVS)与左室后壁(LVPW)厚度、左心室舒张末期内径(LVDd)和收缩末期内径(LVDs)、左室射血分值(LVEF)和左室短轴缩短率(FS)、左室舒张末期容量(LVVd)和收缩末期容量(LVVs);超声征象包括左室室壁瘤和附壁血栓等。结果(1)20例患者PCI术后与术前超声心动图指标相比:LVEF、FS术后明显提高(P<0.01);LVVd术后明显增大(P<0.05)。(2)术前梗死区延展4例(20%)、术后室壁瘤形成1例(5%);术前无左室附壁血栓,术后发生1例(5%)。结论PCI术后左室收缩功能明显提高,左室舒末容量增大,超声心动图为评价PCI术后STEACS患者左心室损害恢复程度提供了量化指标。

Objective To quantitatively evaluate the recovery extent of left ventricular damage on its structures and systolic function in patients with ST-segment elevated acute coronary syndromes （STEACS） after percutaneous corouary intervention （PCI） by echocardiography. Methods 20 hospitalized patients were recruited who were clinically diagnosed as STEACS with significant coronary artery stenosis or infarction. After performing coronary artery angiography （CAG）, PCI were successfully performed in all of them. We compared the differences of parameters and ultrasonic features on echocardiography between before and after PCI. Results （ 1 ） LVEF and FS were significant higher after PCI than those before PCI（ P 〈 0.01 ）, LVVd was significant bigger after PCI than that before PCI（ P 〈0.05）. （2） There were4 cases with infarction-zone expansion before PCI and 1 case with aneurysm after PCI, and there was no case with thrombus before PCI but 1 case with it after PCI. Conclusions There are more significant enhancement on left ventricular systolic function and higher on left ventricular volume in diastolic end after PCI. Thus, echocardiography may offer quantitative indices in evaluating the recovery extent of left ventricular damage in patients with STEACS after PCI.