急性心肌梗死经皮冠状动脉介入治疗术后早期左心室舒张功能  

Left Ventricular Diastolic Function in Patients with Acute Myocardial Infarction at the Early Stage after Primary Percutaneous Coronary Intervention

作　　者：张跃力[1] 韩蓓蓓[2] 薛晓培[1] 张卫兴[1] 王曼[1] 

机构地区：[1]上海交通大学附属第六人民医院超声医学科上海超声医学研究所,上海市200233 [2]上海交通大学附属第六人民医院心内科,上海市200233

出　　处：《中国超声医学杂志》2014年第6期507-511,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨急性ST段抬高心肌梗死（ST-Segment elevation myocardial infarction,STEMI）患者经皮冠状动脉介入治疗术（primary percutaneous coronary intervention,pPCI）后早期左心室舒张功能（left ventricular diastolic function,LVDF）,及无复流对LVDF影响.方法 57例首次急性心肌梗死行pPCI患者,采用超声心动图于pPCI术后24～48 h评价左心室功能、左心室充盈指数E/e＇及心肌灌注.结果 57例患者LVDF分级：正常24例（42.1％）,松弛受损型16例（28.1％）,假性正常化15例（26.3％）,限制性充盈2例（3.5％）,无复流18例（31.6％）患者.无复流组LVDF与复流组间差异有统计学意义,无复流组LVDF分级：正常16.7％,松弛受损型38.9％,假性正常化和限制性充盈44.4％;复流组分别为53.8％、23.1％和23.1％ （P＜0.05）.无复流组E/e＇高于复流组[（9.7±2.9） vs.（7.9±2.5）,P＜0.05].结论 超过半数首次急性STEMI患者pPCI术后早期出现左心室舒张功能障碍.无复流组LVDF较复流组差.Objective To investigate left ventricular diastolic function （LVDF） in patients with acute ST-Segment elevation myocardial infarction （STEMI） at the early stage after primary percutaneous coronary intervention （pPCI） and the effect of no reflow on LVDF.Methods 57 patients with first acute STEMI treated with pPCI were included.LV function,LV filling index E/e＇,and myocardial perfusion were evaluated by echocardiography at 24-48 hours after pPCI.Results LVDF class of the 57 patients was normal in 24 （42.1%） patients,impaired relaxation pattern in 16 （28.1%） patients,pseudonormal filling in 15 （26.3%） patients,and restrictive filling in 2 （3.5%） patients.No reflow occurred in 18 （31.6%） patients.There was significant difference in LVDF between no reflow group and reflow group.LVDF class was normal in 16.7 % patients,impaired relaxation pattern in 38.9 % patients,pseudonormal filling and restrictive filling in 44.4% patients of no reflow group,compared with it in patients of reflow group was 53.8%,23.1%,and 23.1% respectively （P〈0.05）.LV-filling index （E/e＇） was higher in no reflow group than in reflow group （9.7±2.9 vs.7.9±2.5,P〈0.05）.Conclusions More than half of STEMI patients demonstrated diastolic dysfunction at the early stage after pPCI.Patients with no reflow demonstrated poorer LVDF compared with patients with reflow.

关 键 词：舒张功能 心肌梗死 超声心动图 经皮冠状动脉介入治疗术 

分 类 号：R542.22[医药卫生—心血管疾病]