多普勒超声心动图评价直接冠状动脉介入治疗对急性心肌梗死患者左室舒张功能的改善作用

Improved effect of direct percutaneous coronary intervention on left ventricular diastolic function in patients with acute myocardial infarction

目的 探讨直接经皮冠状动脉介入 (PCI)治疗对急性心肌梗死 (AMI)患者左室舒张功能的影响。方法 对 110例发病 12小时内的AMI患者行急诊PCI ,分别于术后 7天、30天行多普勒超声心动图检查 ,并获得左室最大早期舒张血流速度 (E) ,晚期最大舒张血流速度 (A) ,得出舒张早期和晚期最大血流速度比 (E/A)和E峰减速时间(DT)。结果 E峰、E/A术后 30天较术后 7天明显增大 (P <0 .0 5 ) ,A峰、DT明显减少 (P <0 .0 5 )。结论 AMI后尽早实施PCI可以有效开通梗死相关冠状动脉 ,恢复梗死区域心肌血流灌注 ,从而挽救濒危缺血心肌 ,使左室舒张功能得到改善。

Objective To evaluate the improved effects of direct percutaneous coronary intervention on indexes of left ventricular(LV) diastolic filling in patients with acute myocardial infarction(AMI).Methods Direct PCI was performed in 110 patients with AMI onset within 12 hours.Doppler examination was performed at 7th day and 30th day after PCI,and the parameters of LV diastolic function were obtained including peak early diastolic flow velocity(E),peak late diastolic flow velocity(A),ratio of peak early and late diastolic flow elocities(E/A),E spectral decreased time(DT).Results Peak E,E/A ratio increased significantly at 30th day after PCI compared to that at 7th day (P< 0.001 ).Peak A and DT showed a significant decrease(P< 0.05 ).Conclusion Direct PCI can re open the infarct relation artery in patients with AMI as early as possible;The blood flow perfusion in ischemic myocardium can be recovered greatly.LV diastolic function can be improved significantly.