ACS患者PCI围手术期左心室超声功能参数的变化及其与血清心肌损伤程度的关系

Change of left ventricular ultrasonic functional parameters in patients with ACS during periPCI period and their relationship with degree of serum myocardial damage

目的:探讨ACS患者PCI围手术期左心室超声功能参数的变化及其与血清心肌损伤程度的关系。方法:收集在本院接受治疗的ACS患者76例,回顾其治疗方式并分为接受PCI治疗的观察组57例、符合PCI指征但本人或者家属坚决要求保守治疗的对照组19例。对比两组治疗前后左心室超声功能参数水平,血清心肌损伤指标含量差异。采用Pearson检测评估ACS患者治疗后左心室超声功能参数与心肌损伤程度的相关关系。结果:治疗前,两组左心室超声功能参数水平,血清心肌酶谱、心肌凋亡指标含量差异无统计学意义(P>0.05)。治疗后,观察组的左心室超声功能参数LVEDD、LVESD水平低于对照组,SV水平高于对照组;心肌酶谱cTnT、LDH、CK-MB、AST的含量低于对照组;心肌凋亡指标Fas、caspase-3、caspase-12的含量低于对照组,Bcl-2的含量高于对照组(P<0.05)。ACS患者治疗后左心室超声功能参数与心肌损伤程度直接相关。结论:ACS患者接受PCI治疗,可有显著改善左心功能并减轻心肌损伤。治疗后左心室超声功能参数与患者心肌损伤程度直接相关。

Objective：To study the change of left ventricular ultrasonic functional parameters in patients with ACS during peri-PCI period and their relationship with degree of serum myocardial damage.Methods：A total of 76 cases of ACS patients who were treated in our hospital between June 2012 and January 2016 were selected as research subjects,treatment methods were reviewed and then all patients were divided into observation group（n=57）who underwent PCI treatment and control group（n=19）who conformed to PCI indications but underwent conservative treatment under patients＇ or families＇ insistence.Left ventricular ultrasonic functional parameter levels and serum myocardial injury index contents were compared between two groups of patients before and after treatment.Pearson test was used to evaluate the relationship between left ventricular ultrasonic functional parameters and myocardial injury in patients with ACS.Results：Before treatment,differences in left ventricular ultrasonic functional parameter levels as well as serum contents of myocardial enzyme spectrum and myocardial apoptosis indexes were not statistically significant between the two groups of patients（P〉0.05）.After treatment,left ventricular ultrasonic functional parameters LVEDD and LVESD levels in observation group were lower than those in control group while SV level was higher than that in control group;serum contents of myocardial enzyme spectrum cTnT,LDH,CK-MB and AST were lower than those in control group;serum contents of myocardial apoptosis indexes Fas,Caspase-3and caspase-12 were lower than those in control group while Bcl-2content was higher than that in control group（P〈0.05）.The left ventricular ultrasonic functional parameters in ACS patients were directly correlated with the degree of myocardial injury.Conclusions：PCI treatment of patients with ACS can significantly improve left ventricular function and reduce myocardial injury.After treatment,the left ventricular ultrasonic functional parameters are directly correlated with the degree of myocardial injury.