急性心肌梗塞急诊PCI与静脉溶栓对左室收缩功能的影响分析

Effect of emergency PCI and thrombolytic therapy on left ventricfular systolic functin in patients with AMI

目的 :观察急性心肌梗塞 (AMI)急诊经皮冠状动脉介入治疗 (Percutaneouscoronaryinter vention ,PCI)与静脉溶栓后对左室收缩功能的影响。方法 :2 3例AMI静脉溶栓成功的患者观察发病后二周及满 3个月时左心舒张末期内径 (LVED)和射血分数 (EF) ,2 3例AMI急诊PCI术后两周及满 3个月时左心舒张末期内径 (LVED)和射血分数 (EF) ,二者进行比较。结果 :AMI急诊PCI组术后两周及 3个月左心室舒张末期内径 (LVED) (5 8.6± 10 .5比 5 2 .8± 9.4 ,P≤ 0 .0 5 )射血分数LVEF(5 7.5± 10 .5 ) %比 (6 4.8± 11.1) % ,P≤ 0 .0 5AMI溶栓成功组 2周及 3个月时的LVED(5 7.4± 9.5 )比 (6 0 .7± 11.5 ,P≥0 .0 5 ,LVEF(5 2 .3± 9.3) %比 (5 4.6± 9.2 ) %P≥ 0 .0 5 ,PCI组LVEF改变 (5 .12± 0 .33% )较溶栓组的LVEF的改变 (2 .11± 0 .12 % )大P≤ 0 .0 5 ,差异呈显著性。结论 :AMI急诊PCI术后LVED减小 ,LVEF升高 ,静脉溶栓组LVED没有减少 ,LVEF稍升高 ,但不如急诊PCI术明显 ,提示急诊PCI术较单纯静脉溶栓对左室收缩功能更有益。

Objective: To observe the effect of emergency PCI and thrombolytic therapy on left ventricular systolic function in patients with AMI.Methods: 23 cases of first AMI were treated by intravenous thrombolytic therapy with UK while 23 cases of first AMI were treated by emergency PCI,Cardiac function(left ventricular election fraction,LVEF)was assessed by echocardiography during 2 weeks and 3 months after AMI.Results:LVED patiets of emergency PCI were (58.6±10.5 vs 52.8±9.4,P≤0.05)at 2 weeks and 3 months after AMI while LVED patients of thrombolytic therapy were (57.5±9.5 vs 60.7±11.5P≥0.05),LVEF was (52.3±9.3% vs 54.6±9.2%P≥0.05).There was significant difference in LVEF at 3 months after AMI between thrombolytic therapy group and emergency PCI group(54.6±9.2% vs 64.8±11.1%),Changes of LVEF patients with emergency PCI group were larger than that of the patient of obtaining successful thrombolytic therapy at 2 weeks and 3 months (5.12 ±0.33% vs 2.11±0.12%P≤0.05).Conclusion: Emergency PCI for AMI was better left ventricular systolic function than thrombolytic therapy.