冠心病PTCA＋支架术及药物再干预对左心重构和左室功能的影响  

Influence on left cardiac remodeling and left ventricular function in coronary heart disease by performing percutaneous transluminal coronary angioplasty and stent implantation and drug re-intervention therapy

作　　者：赵文强[1] 王俊[1] 谢红珍[1] 吴艳君[1] 潘啸东[1] 

机构地区：[1]江苏省镇江市江苏大学第四附属医院心内科,212003

出　　处：《中国临床实用医学》2008年第3期13-15,共3页China Clinical Practical Medicine

摘　　要：目的研究PTCA＋支架术对左心重构和左室功能的影响及药物再干预的效果。方法对98例冠心病患者经皮冠状动脉介入治疗（PCI）术后1年内4组与术前左心重构、左室功能的临床与超声指标对比研究，对不同PCI策略和不同药物干预效应与左心重构和左室功能的关系进行分析。结果PCI术后1年内4组比术前NYHA心功能分级、6min步行、左房容量指数（LAVI）、左室舒张末容量指数（LVEDVI）、室壁运动缺失分数（WMLF）、射血分数（EF）有极显著的改善（均P〈0．001）；PCI6个月组和12个月组比PCI 1周组上述6项指标有显著的改善（均P〈0．01）；不同PCI策略之间LAVI、LVEDVI、WMLF、EF有显著差别；PCI术后辛伐他丁组、厄贝沙坦组比常规药物组LAVI、LVEDVI、WMLF、EF有显著的改善，而替罗非班组与常规药物组比较4项指标差异不显著。结论冠心病PCI术后1年左心重构和左室功能有显著的改善，恰当的PCI策略和药物再干预对左心重构和左室功能的改善产生更有利的影响。Objective To study influence of percutaneous transluminal coronary angioplasty（PTCA） and stent implantation on left cardiac remodeling and left ventricular function and clinical effect of drug re-intervention in coronary heart disease. Methods 98 petients with coronary heart disease were divided into 4 groups one year after performing percutaneous coronary intervention （PCI） , clinical and echocardiographic indexes of left cardiac remodeling and left ventricular function were examined by comparison of 4 groups of post-PCI versus pre-PCI,influences of different PCI strategy and different drug re-interventions on left cardiac remodeling and left cardiac function were analysed. Results NYHA cardiac function grade,6 minute＇s walk test,left atrial volume index （LAVI） ,left ventricular diastolic-end volume index （ LVDEVI）, eject fraction （ EF）, ventricular Wall movement loss fraction （WMLF） in 4 groups of post-PCI were better than those in pre-PCI （ all P 〈 0. 001 ）. Those in 6 months group and 12 months group of post-PCI were also better than those in 1 week group of post-PCI（ all P 〈0. 01 ）. LAVI,LVEDVI,EF and WMLF were significantly different among different groups of PCI strategy, and better by comparison of Group simvastatin and Group irbesartan versus group of routine drug, but litfle different by Group tirofiban versus group of routine drug in patients undergoing drug re-intervention of post-PCI. Conclusion Left cardiac remodeling and left ventricular function in coronary heart disease have a significant improvement in post-PCIone year, suitable PCI strategy and drug re-intervention have further influence on bettering left cardiac remodeling and left ventricular function.

关 键 词：冠状动脉疾病 冠状动脉介入治疗 经皮 左心重构 左室功能 

分 类 号：R541.4[医药卫生—心血管疾病]