急性心肌梗死患者经皮冠状动脉介入治疗术后心肌灌注水平对心肌存活性的影响  

Effects of different myocardial perfusion on myocardial viability in patients with acute myocardial infraction post primary percutaneous coronary intervention

作　　者：张强[1] 傅向华[1] 信栓力[1] 王小平[1] 王洪涛[1] 常超[1] 韩文生[1] 赵秀峰[1] 邹毅[1] 

机构地区：[1]邯郸市第一医院老年病科,河北邯郸056002

出　　处：《临床心血管病杂志》2008年第11期811-814,共4页Journal of Clinical Cardiology

摘　　要：目的:应用TIMI心肌灌注分级(TMP)分析急性心肌梗死(AMI)患者行经皮冠状动脉介入治疗(PCI)后心肌灌注状况对心肌存活性的影响。方法:所有使梗死相关动脉(IRA)达到TIMI3级血流的AMI患者,根据PCI后即刻冠状动脉造影的TMP分级评价的心肌灌注状况,分为A组(TMP为2～3级,57例),B组(TMP为0～1级,31例)。运用静息及含服硝酸甘油介入99mTc-MIBI心肌灌注断层显像(MPI)来评价2组的存活心肌并于12周再次行静息99mTc-MIBI心肌灌注断层显像(MPI)评价存活心肌的恢复情况。结果:术后1周心肌存活面积A组高于B组[(5.43±4.89):(4.12±4.15),P<0.05],术后12周A组心肌缺损面积改善程度较B组明显[A组由(26.54±12.71)降至(17.86±11.59),P<0.05),B组由(39.37±16.31)降至(37.19±10.79),P>0.05]。结论:AMI患者行PCI术后心肌组织灌注TMP分级2～3级,可提高存活心肌的数量,心肌恢复较快。Objective： To investigate myocardial viability post primary percutaneous coronary intervention （PCI） in patients with acute myocardial infraction （AMI） in terms of TIMI myocardial perfusion grade （TMP）. Method：A total of 88 patients with post-procedural TIMI 3 grade flow of IRA was assigned to TMP 2-3 grade （group A, n=57） and TMP 0 1 grade （group B, n=31）. All the patients underwent rest and nitroglycerin ^99mTc MIBI myocardial perfusion imaging （MPI） to assess the myocardial viability. MPI was repeated at 12 weeks after PCI. Result： Myocardial viability area was significantly higher in group A than that in group B at 1 week post PCI （5.43±4.89% vs 4.12±4.15%, P〈0.05）. Myocardial defect area was smaller in group A than that in group B at 12 weeks post PCI （17.86±11.59% vs 37.19±10. 79%, P〈0.05）. Conclusion：Myocardial reperfusion （TMP 2-3 grade） in patients with AMI post PCI contributes to improve the myocardial viability.

关 键 词：心肌梗死 经皮冠状动脉介入治疗 TIMI心肌灌注分级 心肌存活性 

分 类 号：R541.4[医药卫生—心血管疾病]