心脏彩超在心肌梗死后慢性心衰心脏同步性检测中的临床作用

The cfinical values of echocardiography for the chronic heart failure cardiac synchronization detection in the myocardial infarction after intervention

目的探讨心脏彩超在心肌梗死后慢性心衰心脏同步性检测中的临床作用。方法选择2013年1月到2015年6月在北京中医医院顺义医院进行诊治的心肌梗死患者92例，根据随机数字表法分为治疗组和对照组各46例。对照组给予介入治疗，治疗组在对照组治疗的基础上给予心脏再同步化治疗。结果所有患者介入治疗均成功。介入后14d治疗组和对照组的LVESVI、LVEDVI都明显低于介入前[LVESVI（24．09±5．09）ml／m^2比（33．98±4．56）ml／m^2、LVEDVI（54．98±5．91）ml／m^2比（61．93±6．33）ml／m^2,P〈0．05]，治疗组降低更明显（P〈0．05）。介入后14d治疗组和对照组的Trs-Avg-12值比治疗前显著降低（P〈0．05），治疗组降低更明显（P〈0．05）。两组介入前后的Trs-Avg-6b组内与组间对比未见统计学差异（P〉0．05）。所有患者介入后随访调查6个月，治疗组的慢性心力衰竭、再次心肌梗死、恶性心律失常和靶病变血管重建等主要心脏不良事件明显少于对照组（P〈0．05）。结论心肌梗死后慢性心衰心脏彩超显示多存在心室收缩不同步情况。心脏再同步化治疗辅助介入治疗能有效改善心功能，改善患者的心室收缩不同步情况，减少慢性心力衰竭等主要心脏不良事件的发生。

Objective To investigate the clinical values of echocardiography for the chronic heart failure cardiac synchronization detection in the myocardial infaretion after intervention. Methods From January 2013 to June 2015, 92 patients with myocardial infarction were selected in our hospital, and were equally divided into the treatment group and the control group aeeording to the random number table. The control group received surgical intervention, and the treatment group were added the resynchronization therapy. Results All patients were involved in successful treatment. The postoperative 14 d LVESVI and LVEDVI values in the two groups were significantly lower than before intervention [LVESVI （24.09±5.09）ml/m^2 vs （33.98±4.56）ml/m^2, LVEDVI （54.98±5.91）ml/m^2 vs （61.93±6.33）ml/m^2, P〈0.05 ], while the postoperative 14 d LVESVI and LVEDVI values in the treatment group were also significantly lower than the control group （P〈0.05）. The postoperative 14 d Trs- Avg-12 value in the two groups were significantly lower than before intervention（P〈O.05）, while the postoperative 14 d Trs-Avg-12 values in the treatment group were also significantly lower than the control group （P〈0.05）. The Trs-Avg-6b compared between the two groups and before and after the intervention were not statistically significant （P〉0.05）. All patients were involved in the followed-up survey after six months. The chronic heart failure, myocardial infarction again, malignant arrhythmias and target lesion revaseularization and other major adverse cardiac events in the treatment group were significantly less than the control group （P〈0.05）. Conclusion The chronic heart failure in the myocardial infarction after intervention were showed more ventricular dyssynchrony by the eehoeardiography, the resynehronization therapy assisted cardiac interventional therapy can improve heart function, improve the ventrieular dyssynchrony circumstances, reduee chronic heart failure and the other major adverse cardiac events.