经皮冠状动脉介入治疗对心肌梗死患者心功能的影响  

Effect of percutaneous coronary intervention on cardiac contractive function of patients with myocardial infarction

作　　者：杨丽霞[1] 齐峰[1] 王先梅[1] 石燕昆[1] 王燕[1] 郭传明[1] 李丽俐[1] 任丽[1] 

机构地区：[1]成都军区昆明总医院心内科,云南昆明650032

出　　处：《心脏杂志》2004年第4期329-331,共3页Chinese Heart Journal

摘　　要：目的 :评价心肌梗死并左心功能不全患者经皮冠状动脉介入 (PCI)治疗对左心收缩功能和左心室重构的影响。方法 :急性心肌梗死 (AMI)患者 30例 ,陈旧性心肌梗死 (OMI) 2 2例 ,经 PTCA、支架术治疗 ,术后随访 3个月 ,超声心动图测定左室舒张末内径 (L VEd)、左心房内径 (L Ad)、左室舒张末容积 (L VEDV)、左室收缩末容积(L VESV)、左室射血分数 (L VEF)和左室短轴缩短率 (L VFS) ,比较治疗前后各参数的变化。结果 :PCI治疗后L VEd、L Ad、L VEDV、L VESV显著减少 (P<0 .0 1)、L VEF和 L VFS显著增高 (P<0 .0 1) ,尤以 AMI组明显 ,并且冠状动脉血运重建的时间越早 ,心功能恢复越好。结论 :心肌梗死并左心功能不全患者尽早 PCI治疗可明显改善左心室收缩功能 ,可部份阻抑左心室重构。AIM: To assess the effect of percutaneous coronary intervention (PCI) on the cardiac contractive function and remodeling of the left ventricle of myocardial infarction patients over a 3-month period. METHODS: 30 cases with acute myocardial infarction (AMI) and 22 old myocardial infarction (OMI) patients were treated by percutaneous transluminal coronary angioplasty (PTCA) and stent. Three-month follow-up was conducted after PCI. The left ventricular end diastolic diameter (LVEDd), left atrial diameter(LAd), left ventricular end diastolic volume(LVEDV), left ventricular end systolic volume(LVESV), left ventricular ejection fraction(LVEF) and the left ventricular fractional shortening (LVFS) indexes were measured by Doppler echocardiography and the parameters before and after PCI were compared. RESULTS: The LVED, LAD, LVEDV, LVESV indexes were significantly reduced (P<0.01) in after PCI than in before PCI. LVEF and LVFS indexes were increased apparently (P<0.01), especially in the AMI group. The earlier the revascularization of coronary artery, the better the cardiac function recovers. CONCLUSION: The AMI patients with left ventricular dysfunction should be treated by PCI as soon as possible, which can improve the left ventricular contractive function apparently and partly impede the remodeling of the left ventricle

关 键 词：心肌梗塞 经皮冠状动脉介入术 心功能不全 

分 类 号：R542.22[医药卫生—心血管疾病]