慢性闭塞病变患者介入治疗后心肌血流和心电图及心功能变化

Changes of myocardial blood flow, electrocardiogram and heart function after PCI for chronic total coronary occlusion

目的探讨慢性冠状动脉闭塞(CTO)病变患者PCI后梗死相关动脉(IRA)闭塞血管TIMI血流和心肌灌注(TMP)血流的变化;了解CTO病变PCI后心电图、心功能的变化。方法选择心绞痛或心电图异常的住院患者42例行冠状动脉造影检查,确诊为CTO病变,进行PCI支架置入术。分析术前、术后IRA的TIMI血流、TMP血流、心电图和心功能的变化。结果 CTO病变PCI后IRA的TIMI血流、TMP血流3级者分别为36例(85.7%)和25例(59.5%);PCI前、后心绞痛、心功能比较差异有统计学意义(P<0.05,P<0.01)。心电图Q波、ST段、T波异常与相关CTO均<30%,PCI前、后心电图显示Q波、ST段、T波异常共40次,前、后对比共17次(42.5%),无异常者23次(57.5%)。结论 CTO病变行PCI后,对冠状动脉再通、改善心肌血流灌注、改善心功能、缓解心绞痛症状以及对心电图异常的改变均有意义。

Objective To evaluate the changes of TIMI blood flow, myocardial perfusion（TMP） blood flow,electrocardiogram and heart function after percutaneous coronary intervention（PCI） in patients with chronic coronary total occlusion（CTO）. Methods From Jan 2004 to March 2008,42 patients with CTO diagnosed by coronary artery angiography and treated with PCI were enrolled in this study. The changes of TIMI blood flow, TMP blood flow, electrocardiogram and heart function after operation were analyzed. Results The grade 3 TIMI and TMP blood flow after PCI were seen in 36 cases（85. 7%） and 25 cases（59. 5%） respectively. Clinical symptoms and the heart function were better than those before PCI. Conclusion The patients with CTO could get benefit in heart function,symptoms and electrocardiogram from PCI.