急性心肌梗死急诊介入治疗对左室舒张功能的影响

Influence of emergency percutaneous coronary intervention therapy on left ventricular diastolic function in patients with acute myocardial infarction

目的通过多谱勒超声心动图探讨急诊介入治疗对急性心肌梗死(AMI)患者左室舒张功能的影响。方法将急性心肌梗死患者90例分为急诊经皮冠状动脉介入治疗(PCI)治疗组45例、药物溶栓组11例、药物保守治疗组34例。所有患者于发病后1周行多谱勒超声心动图检查,测定二尖瓣舒张期血流频谱E峰、A峰,并计算E/A比值,同时测定肺静脉血流频谱波Ar波峰,左室舒张早期传播速度Vp及二尖瓣环舒张早期峰值运动速度Em。结果急诊PCI组与溶栓治疗组及药物保守治疗组比较,Ar波峰低,Vp及Em速度增快(P<0.05),E/A比值比药物保守治疗组高(P<0.05),但与溶栓治疗组无显著性差异(P>0.05)。溶栓组与药物保守治疗组比较Ar波峰低,Vp及Em速度增快(P<0.05),E/A比值高(P<0.05)。结论急性心肌梗死患者行急诊介入治疗可明显改善左室舒张功能。

Objective To assess the influence of emergency percutaneous coronary intervention therapy on left ventricular diastolic function in patients with acute myocardial infarction by Doppler eehocardiogram. Methods 90 cases of AMI were divided into three groups： 45 cases of emergency PCI, 11 cases of thrornbolytic therapy and 34 cases of non reperfusion. Transmittal E/A, pulmonary venous flow velocity Ar, left ventricular flow propagation velocity during early diastole Vp, mitral annulus peak velocity of early diastolic wave Em were measured at two weeks after AMI. Results Vp and Em increased in Emergency PCI group compared with the other two groups, while the Ar was lower than those of other two groups （ P 〈 0.05）. E/A ratio in emergency PCI group is higher than that in non-reperfusion group （ P 〈 0.05）. but there were no significant difference in emergency PCI and thrombolytic therapy group. Compared with the non reperfusion group, Vp and Em, as well as E/A ration increased, while Ar decreased, in thrombolytic therapy group. Conclusion Emergency PCI can improve left ventricular diastolic ftmction.