冠状动脉介入治疗缺血性心肌病冬眠心肌的临床研究

Clinical study of the treatment of PCI on hibernating myocardium in ischemic cardiomyopathy with heart fail- ure.

目的探讨冠状动脉介入治疗对缺血性心肌病患者冬眠心肌的治疗效果。方法通过对1998年8月至2006年12住东莞市石龙人民医院确诊为缺血性心肌病并心功能不全的121例患者,随机分为冠状动脉介入治疗组(以下简称治疗组 n=60)和内科常规药物治疗组(以下简称对照组 n=61),观察两组患者在治疗3个月后纽约心功能分级、心脏彩超左室大小及射血分数的变化情况。结果两组患者入院时纽约心功能分级、心脏彩超左室大小及射血分数差异无显著性意义,但治疗组3个月后纽约心功能分级的改善明显优于对照组(P<0.05);治疗组左室缩小程度及射血分数的改善在治疗3个月后较入院时差异有显著性意义(P<0.05)并明显优于对照组(P<0.05),对照组治疗前后左室缩小程度及射血分数的改善则无明显变化。结论介入治疗在缺血性心肌病心功能不全患者中的应用可以显著地改善患者的纽约心功能分级、改善左室重构及射血分数,其机制与改善缺血性心肌病患者冬眠心肌供血有关。

Objective To evaluate the treatment of PCI on hibernating myocardium..in ischemic cardiomyopathy with heart failure.Methods All patients identified iscbemic cardiomyopathy with heart failure by coronary angiography were randomly divided into PCI group and contrast group.61 patients in contrast group were just received the treatment of medi- cine while 60 patients in PCI group were received PCI as well.Compare the grade of NYHA ,the size of left ventricle and the ejection fraction r between two groups3 months late.Results There were no deference between groups in the grade of NYHA,the size of left ventricle and the ejection fraction at the beginning of treatment,but the grade of NYHA,the size of left ventricle and the ejection fraction in PCI group were better than contrast group 3 months later(P<0.05).Conclusion The effect of PCI was better than medicine only in ischemic cardiomyopathy with heart failure.The mechanism of The effect of PCI was that PCI could improve the supply of coronary artery and the function of hibernating myocardium.