经皮冠状动脉介入治疗对缺血性心肌病患者左心室功能的影响

The effect of percutaneous coronary intervention on left ventricular function in patients with ischemic cardiomyopathy

目的 探讨经皮冠状动脉介入（PCI）治疗对缺血性心肌病（ICM）患者左心室功能的影响.方法 将65例ICM患者随机分为PCI治疗组（32例）和药物治疗组（33例）.PCI治疗组接受PCI和药物治疗;药物治疗组接受单纯药物治疗.随访1年,6和12个月时行心脏超声心动图检查,比较2组患者左心室舒张末容积（LVEDV）和左心室射血分数（LVEF）以及1年心血管事件发生情况.结果 PCI治疗组左心室功能改善优于药物治疗组[LVEF：治疗后6个月（38.0±2.4）%比（36.0±2.8）%,治疗后12个月（43.0±2.1）%比（40.0±2.5）%,P＜0.05],PCI治疗组1年内急性心肌梗死、急性左心衰竭、心源性死亡以及因心功能不全和/或严重心肌缺血再次住院发生率低于药物治疗组[分别为6.2%比24.2%,9.4%比30.3%,3.1%比18.2%,18.7%比54.5%,均P＜0.05].结论 PCI对ICM治疗有效,与单纯药物治疗比较,PCI加药物治疗能更有效地改善患者左心室功能及减少心血管事件发生.

Objective To investigate the effect of percutaneous coronary intervention （PCI） on left ventricular function of patients with ischemic cardiomyopathy. Methods The 65 patients with ischemic cardiomyopathy were divided into PCI group（32 cases） and medicine group（33 cases）. PCI group accepted PCI and medicine, medicine group accepted medicine only. They were followed up for one year. Transthoracic eahocardiography （TTE） in sixth and twelfth months were examined. The LVEDV, LVEF and cardiovascular events in one year between two groups were compared. Results The improvement of left ventricular function in PCI group was better than that in medicine group. [LVEF：sixth month after treatment（38.0±2.4）% vs （36.0±2.8）%,twelfth month（43.0± 2.1）% vs （40.0±2.5）%,P〈0.05]The incidence rates of the events of acute myocardial infarction,acute left heart failure, cardiac death, rehospitalization due to cardiac insufficiency or severe myocardiac ischemic in PCI group were lower than those in medicine group in one year[6.2% vs 24.2% ,9.4% vs 30. 3% ,3.1% vs 18.2% ,18.7% vs 54.5% ,P〈0.05]. Conclusions It is effective to treat the ischemic cardiomyopathy with PCI. The PCI combined with medicine is superior to medicine only in improving left ventricular function and decreasing cardiovascular events in ischemic cardiomyopathy.