选择性经皮冠脉腔内成形术逆转冠心病左室重构疗效观察25例  

Left ventricular remodling reversed by elective angioplasty in 25 patients with coronary heart disease

作　　者：魏晓冬[1] 陈士良[1] 扎拥 蔡天鹏[1] 俞集会[1] 程志乾[1] 

机构地区：[1]武警江苏总队医院内一科

出　　处：《武警医学》1998年第6期314-316,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：为探讨经皮冠脉腔内成形术（ＰＴＣＡ）能否逆转冠心病（ＣＨＤ）患者的左室重构（ＬＶＲＭ），对实施选择性ＰＴＣＡ的２５例冠心病患者，应用二维超声心动图（２ＤＥ）动态观察其围ＰＴＣＡ期左室射血分数（ＬＶＥＦ）、每搏量（ＳＶ）、左室舒张末容积（ＬＶＥＤＶ）及左室收缩末容积（ＬＶＥＳＶ）的演变。结果发现扩大的左室容积在围术期中明显缩小。其中１５例心肌梗死后有ＬＶＲＭ者７例，其术后ＬＶＥＳＶ首先回缩（Ｐ＜００５），随后ＬＶＥＳＶ及ＬＶＥＤＶ均显著缩小（均Ｐ＜００１）；而无ＬＶＲＭ者（ｎ＝８），ＬＶＥＳＶ及ＬＶＥＳＶ则无变化（均Ｐ＞００５）。无论有无ＬＶＲＭ，围术期ＬＶＥＦ及ＳＶ均无变化（均Ｐ＞００５）。提示在选择性ＰＴＣＡ围术期中，ＬＶＲＭ可明显减轻；也表明在反映ＬＶ功能的２ＤＥ指标中。To eveluate the effects of (PTCA) on left ventricular function and volume in patients with left ventricular remodling (LVRM), 25 patients with CHD were analyzed As a whole, left ventricular function and volume ameliorate markedly after PTCA Among them, 15 patients with old myocardial infarction were divided into two groups: LVRM and Non-LVRM groups Two-dimensional echocardiography (2DE) examination were done at the time pre-and post-PTCA at 1～3 d, 7～10 d and 20～40 d LVEDV and LVESV were measured by using the modified Simpson′s method and recorded with videography In LVRM group (n=7) LVESV begun to decline at 1～3 d after PTCA (P<005), LVEDV and LVESV were decreased significantly at 7～10 d after PTCA (both P<001) In Non-LVRM group (n=8) LVEDV and LVESV were no change (both P>005) LVEF and SV in two groups kept stable (all P>005) around the peri-PTCA period Therefore, it is believed that elective PTCA may reverse LVRM And, in assessing left ventricular function with 2 DE, LVEV and LVEDV are more sensitive than LVEF and SV

关 键 词：PTCA 冠心病 LVRM 超声心动图 2DE 治疗 

分 类 号：R541.405[医药卫生—心血管疾病]