急性心肌梗死溶栓治疗后心脏收缩功能的改善

Improvement of cardiac contraction function in acute myocardial infarction treated by venous thrombolysis

为观察急性心肌梗死（ＡＭＩ）患者，静脉溶栓疗效与心脏收缩功能之关系。选８８例接受静脉溶栓治疗的ＡＭＩ患者，分为两组：溶栓再通组６６例及未溶通组２２例。以Ｋｉｌｉｐ分级判定临床心功能，超声心动图测定左室射血分数（ＬＶＥＦ）。结果显示：①重度左心功能不全（即ＫｉｌｉｐⅢ级）患者，溶通组明显少于未溶通组（１０．６％比３１．８％）；②室壁瘤出现率，溶通组明显少于未溶通组（９．１％比３６．４％）；③ＬＶＥＦ值，溶通组明显高于未溶通组（５８．３±１０．５比５０．９±１１．９）。以上比较的Ｐ值均＜０．０１。可认为经静脉溶栓使梗死相关血管再灌注后的ＡＭＩ患者，左心室收缩功能一定程度上得以保护。

The objective of the present paper is to observe the relationship between the efficacy of venous thrombolytic therapy on aucte myocardial infarction(AMI) and cardiac function.Eightyeight patients with AMI received venous thrombolytic therapy,and were divided into two groups: 66 cases of reperfusion and 22 noreperfusion. The clinical cardiac function was judged by killipgrading,and the left ventricular ejection fraction(LVEF) were determined by echocardiogram. ①The cases of severe left heart insufficiency in reperfusion group were less than that in noreperfusion group (10.6% vs 31.8%). ②The rate of ventricular aneurysm was lower in group reperfusion than that in noreperfusion group (9.1% vs 36.4%,P<0.005). ③LVEF value was higher in reperfusion group than in noreperfusion group(58.3±10.5 vs 50.9±11.9,P<0.01). The left cardiac function of contraction can be protected to certain extent for patients with AMI receiving venous thrombolytic therapy after the reperfusion of infarct related coronary artery.