PCI对恢复期心肌梗死患者左室重构的作用

Impact of percutaneous coronary intervention performed during recovery phase on left ventricular remodeling in acute myocardial infarction patients

目的评价经皮冠状动脉介入治疗(PCI)急性心肌梗死恢复期对患者左室重构的临床作用。方法对50例首次心肌梗死患者,平均于发病(3.8±2.1)周行冠状动脉造影,并进行前瞻性研究。按梗死相关冠状动脉是否进行PCI及PCI成功与否分为PCI组(28例PCI成功患者)和对照组(22例未行PCI患者)。对PCI组患者,于术前[平均(4.5±3.3)d]及术后随访期[平均(6.9±1.3)个月]及对照组患者于相当于PCI组术前和随访期时间进行心脏超声检查,以评价左室容量和收缩及舒张功能的改变。结果PCI组术后随访期左室容量较术前减小、左室收缩功能明显改善,而左室舒张功能无明显变化。与对照组相比,PCI组随访期左室容量较小,而收缩及舒张功能明显好于对照组。结论在心肌梗死恢复期,PCI尚能阻止患者的左室重构,改善患者的远期左室功能,具明显临床有益作用。

Objective To assess the impact of percutaneous coronary intervention （PCI） performed during recovery phase on left ventricular （LV） remodeling in acute myocardial infarction （AMI） patients. Methods Twenty-eight patients （group Ⅰ ） with first-time MI and having received successful PCI during recovery phase were prospectively studied; 22 patients （group Ⅱ ） with first-time AMI but without receiving PCI were enrolled as control. In both groups, serial echocardiographic examinations were performed before PCI [（4.5 ± 3.3） days] and during follow up [（6.9 ± 1.3） months after PCI] to assess the changes in LV volumes, systolic and diastolic function. Results In group Ⅰ , LV volume was decreased and systolic function was improved after PCI during follow-up, but LV diastolic function remained unchanged. LV volume was smaller and systolic and diastolic function was better in group I than in group Ⅱ （all P〈 0. 05）. Conclusions PCI performed during the recovery phase of acute myocardial infarction may significantly improve the heart function.