直接和择期冠状动脉介入治疗对急性心肌梗死患者左心室重构和左心功能的影响被引量：10

Influence of direct and selective percutaneous coronary intervention on ventricular remolding and function in acute myocardial infarction patients

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摘要目的：探讨急性心肌梗死（AMI）患者直接及择期经皮冠状动脉介入治疗（PCI）对左心室重构和左心功能的影响。方法：对42例初次发病、发病时间在12h以内或12～24h之间的AMI患者，行直接PCI；对30例AMI患者行择期PCI。于术后2、15和30周行二维超声心动图检查并记录有关心脏事件。结果：术后2、15周直接PCI组的左心室收缩末容积指数（ESVI）、左心室舒张末容积指数（EDVI）、左心室射血分数（LVEF）和梗死区室壁运动指数（RWMI）均显著优于择期PCI组（P〈0．05或P〈0．01）。择期PCI组、直接PCI组15和30周ESVI、EDVI、LVEF及RWMI与2周时比均有显著改善（P〈0．05，P〈0．01）。至30周时，直接PCI组和择期PCI组EDVI、LVEF和RWMI差异无统计学意义，而ESVI差异有统计学意义（P〈0．05）。全心室壁运动指数在2组间始终差异无统计学意义（P〉0．05）。结论：直接PCI及择期PCI均可有效抑制左心室重构和改善左心室功能，但直接PCI更优于择期PCI。 Objective： To explore the influences of direct and selective percutaneous coronary intervention （PCI） on ventricular remolding and function with acute myocardial infarction （AMI） patients. Method：Direct PCI was performed on acute myocardial infarction patients within 12 or 24 hours of onset. Selective PCI was performed on those patients without indication of direct PCI. After about 2,15 or 30 weeks of the operation, all the patients were checked with index of end systolic volume （ESVI）, end diastolic volume （EDVI）, ejection fracture （LVEF） and relative wall movement （RWMI）of left ventricle by echocardiography. Result：There were 72 pat rents selected in this study,including 58 male and 14 female with average age of 57.95±8.94, 42 cases in direct PCI group and 30 in selected PCI group. After two weeks of PCI, the ESVI, EDVI, LVEF and RWMI were significantly improved （ P 〈0.05, P〈0.05, P〈0.01, P〈0. 05） in direct PCI group. In selected group, the ESVI （ P〈0.01, P〈0.01）,EDVI（P〈0.05, P〈0.01）,LVEF（P〈0.05, P〈0.01） and RWMI（P〈0.05, P〈0.01） were significantly better in 15 and 30 weeks compared with those in 2 weeks after PCI. In 30 weeks after PCI , EDVI （ P〉0. 05）.LVEF（ P 〉0.05）and RWMI（ P 〉0.05） were not significantly different in the two groups, except of ESVI （ P〈0. 05）. The indexes of globe wall movement were not significantly different in the two groups all the time. Conclusion： All the direct and selective PCI can inhibit left ventricular remolding and improve left ventricular function. Direct PCI is better than selective PCI.

作者马骏邱建向定成袁彬彬吴小岩冯力洪长江何建新

机构地区广州军区广州总医院心内科广州军区广州总医院超声科

出处《临床心血管病杂志》 CAS CSCD 北大核心 2006年第12期724-726,共3页 Journal of Clinical Cardiology

关键词心肌梗死冠状动脉介入治疗心室重构心室功能 Myocardial infarcton Percutaneous coronary intervention Ventricular function, left Ventricular remolding

分类号 R542.2 [医药卫生—心血管疾病]

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