冠状动脉慢性完全闭塞病变再灌注介入治疗对左室重构的影响  

Effects of late interventional reperfusion therapy on left ventricular remodeling in patients with chronic total occlusion

作　　者：赵华丽[1] 郝清卿[1] 

机构地区：[1]河北医科大学第二医院干部病房,河北石家庄050000

出　　处：《临床荟萃》2007年第8期551-554,共4页Clinical Focus

摘　　要：目的探讨再灌注介入治疗对冠状动脉慢性完全闭塞(CTO)病变患者左室重构的影响。方法81例冠状动脉造影显示符合CTO病变患者,根据是否对CTO冠状动脉行经皮冠状动脉介入治疗(PCI)将患者分为PCI治疗组(37例)和药物保守治疗组(44例);在冠脉造影术后1周和6个月行超声心动图检查,计算校正的舒张末期容积指数(LVEDVI)、收缩末期容积指数(LVESVI)和左室质量指数(LVMI),评价左室重构情况。结果两组冠状动脉造影资料比较均无统计学意义;冠状动脉造影后1周时,两组LVEDVI、LVESVI和LVMI比较差别均无统计学意义;6个月时,PCI治疗组LVEDVI较前降低[(77.67±15.37)ml/m2vs(70.24±9.85)ml/m2(P<0.05)],药物保守治疗组LVEDVI、LVESVI和LVMI均较前有明显升高[LVEDVI(79.98±13.75)ml/m2vs(88.77±15.59)ml/m2,LVESVI(37.55±12.93)ml/m2vs(43.52±12.88)ml/m2,LVMI(108.18±14.51)g/m2vs(118.86±21.60)g/m2(P<0.05或P<0.01)],PCI治疗组较药物保守治疗组LVEDVI、LVESVI、LVMI均有显著降低[LVEDVI(70.24±9.85)ml/m2vs(88.77±15.59)ml/m2,LVESVI(28.62±7.01)ml/m2vs(43.52±12.88)ml/m2,LVMI(102.86±17.44)g/m2vs(118.86±21.60)g/m2(P<0.01)]。结论对于冠状动脉慢性闭塞病变患者,晚期再灌注介入治疗可以阻抑心室重构。Objective To elucidate the effects of late interventional reperfusion on the patients with chronic total occlusion（CTO）. Methods Eighty-one patients with CTO were enrolled. Depending on whether the CTO coronary artery underwent percutanous coronary intervention（PCI）, the patients were divided into PCI group （n= 37）and medication group（ n = 44）. All the patients underwent ultrasonic cardiography（UCG） in 1st week and 6th month after the coronary angiography （CAG） to calculate the left ventricular end-diastolic volume index （LVEDVI）, the left ventricular end-systolic volume index（LVESVI） and the left ventricular mass index（LVMI）. Results There was no significant difference of CAG result between PCI group and medication group. LVEDVI, LVESVI and LVMI had no significant differences between two groups one week after CAG. After six months, in PCI group LVEDVI was apparently decreased[（77.67 ± 15.37） ml/m^2 vs （70.24 ± 9.85） ml/m^2 （ P〈0.05）], while in medication group LVEDVI, LVESVI and LVMI were more increased than those at 1st week[LVEDVI（79.98±13.75） ml/m^2 vs （88.77±15.59） ml/m^2 ,LVESVI（37.55±12.93） ml/m^2 vs （43.52±12.88） ml/m^2 , LVMI（108.18±14.51） g/m^2 vs （118. 86±21.60） g/m^2 （ P〈0.05 or P〈0.01）]. LVEDVI, LVESVI and LVMI after six months were significantly reduced in PCI group than those in medication group [ LVEDVI （70.24 ± 9.85） ml/m^2 vs （88.77 ± 15.59） ml/m^2 , LVESVI（28.62±7.01） ml/m^2 vs （43.52±12.88） ml/m^2,LVMI（102.86±17.44） g/m^2 vs （118.86±21.60） g/m^2 （ P〈0.01）]. Conclusion For the patients with chronic total occlusions, late interventional reperfusion therapy has benefieial effect in the nrevention of left ventricular remodeling.

关 键 词：冠状动脉疾病 再灌注 血管成形术 经腔 经皮冠状动脉 心室重构 

分 类 号：R543.3[医药卫生—心血管疾病]