直接经皮冠状动脉介入治疗对急性心肌梗塞后左室重构的影响  

The Effects of Direct Percutaneous Coronary Intervention on Left Ventricular Remodeling after Acute Myocardial Infarction

作　　者：杨兴义[1] 屈昌文[1] 陆咏[1] 黄斌雄[1] 

机构地区：[1]上海市第一人民医院分院心内科,上海200081

出　　处：《华西医学》2008年第2期293-295,共3页West China Medical Journal

摘　　要：目的：研究直接经皮冠状动脉介入治疗（直接PCI）及常规药物治疗对急性心肌梗塞（AMI）后左室重构的影响。方法：应用超声心动图对65例AMI患者进行随访。结果：12-24个月随访显示：直接PCI组患者的心功能分级、再次住院数及死亡数较常规治疗组显著降低（P〈0.05）。左室收缩末容积（LVESV）较常规治疗组减小（P〈0.01）,但左室射血分数（LVEF）增高（P〈0.01）,球形指数（SI）显著增加（P〈0.01）,室壁运动指数（WMI）显著降低（P〈0.05）,左室质量指数（LVMI）也显著降低（P〈0.01）。AMI后1个月及12-24个月随访显示：常规治疗组AMI患者12-24个月时LVESV、LVEF及SI较1个月时显著改变（P〈0.01）,但WMI及LVMI无显著差异（P〉0.05）。直接PCI组AMI患者除WMI在12-24个月时较1个月时显著降低（P〈0.01）外,余指标均无显著差异（P〉0.05）。结论：直接PCI治疗能够明显改善AMI后患者的左室重构,使AMI后心衰、再次住院及死亡发生率降低。Objective：To investigate the effects of direct percutaneous coronary intervention（PCI）and routine medical therapy on left ventricular remodeling after acute myocardial infarction（AMI）.Mothods：A total of 65 patients were investigated by echocardiography at the first-month and 1-2 year after AMI.Results：There were significant decreased in grade of NYHA and re-hospitalization and mortality rate（P〈0.05）in patients received direct PCI compared with patients received routine medical therapy.Left ventricular end-systolic volume（LVESV）and wall motion index（WMI）significantly decreased（P〈0.01）,and left ventricular ejection fraction（LVEF）and spherical index（SI）increased（P〈0.01）.There was significant difference in LVESV and LVEF and SI in patients received routine medical therapy（P〈0.01）,however,not so in patients received direct PCI（P〉0.05）between the first month and 1-2 year after AMI.Conclusions：Direct PCI can attenuate left ventricular remodeling after AMI.

关 键 词：血管成形术 经腔 经皮冠状动脉 左室 重构 心肌梗塞 

分 类 号：R542.22[医药卫生—心血管疾病]