冠状动脉介入联合心脏再同步化治疗缺血性心肌顽固性心力衰竭

目的探讨冠状动脉介入联合心脏再同步化治疗缺血性心肌病顽固性心力衰竭的临床疗效。方法通过对50例缺血性心肌病顽固性心力衰竭患者,随机分为对照组和实验组(n=25)。对照组患者给予冠状动脉治疗,实验组患者冠状动脉介入联合心脏再同步化治疗。观察比较2组患者的治疗效果、并发症发生情况、心功能差异。结果实验组患者治疗总有效率为96%,对照组患者为80%,差异有统计学意义(P<0.05);实验组患者心律失常、脑血栓、再发心肌梗死和死亡并发症发生率分别为4%、8%、8%和4%,明显低于对照组患者(P<0.05);实验组患者超声心电图LVEF(左心射血分数)为(49.9±9.7)%,较对照组患者明显提高(P<0.05);LVEDD(左室舒张末径)为(60.2±12.1)mm,较对照组患者明显降低(P<0.05);6 min步行距离为(387±53)m,较对照组患者明显提高(P<0.05)。结论对缺血性心肌病顽固性心力衰竭患者采取冠状动脉介入联合心脏再同步化可明显提高治疗效果,降低并发症发生率,改善患者心功能。冠状动脉介入联合心脏再同步化对治疗缺血性心肌病顽固性心力衰竭具有重要临床意义。

Objective To investigate clinical efficacy of coronary intervention combined cardiac resynchronization therapy in ischemic cardiomyopathy refractory heart failure. Methods 50 cases of ischemic cardiomyopathy with refractory heart failure hospital were randomly divided into control group and experimental group, each had 25 patients. The control group were treated with coronary intervention, patients in the experimental group combined cardiac resynchronization therapy. Treatment effect, the incidence of complications, heart function differences of two groups were observed. Results The effect of experimental group was significantly higher than that in control group （P〈0.05）;the incidence of heart disorders, cerebral thrombosis, recurrent myocardial infarction and death complication rate in the experimental group was significantly lower than those in the control group （P〈0.05）;echocardiography LVEF were significantly increased in experimental group than in the control group, LVEDD were significantly lower than the control group, 6 min walking distance significantly increased （P〈0.05）. Conclusion For patients with ischemic cardiomyopathy heart failure refractory to take coronary intervention combined cardiac resynchronization therapy can significantly improve the effectiveness and reduce the incidence of complications, improve cardiac function. Coronary intervention combined cardiac resynchronization therapy in ischemic cardiomyopathy for refractory heart failure has important clinical implications.