前壁及广泛前壁心肌梗死患者溶栓前后心脏储备功能观察  

Effect of thrombolytic therapy on cardiac reserve function in patients with AMI

作　　者：李明[1] 祝家庆[1] 王燕妮[1] 袁祖贻[1] 

机构地区：[1]西安交通大学第一医院心内科

出　　处：《临床心血管病杂志》2002年第6期253-255,共3页Journal of Clinical Cardiology

摘　　要：目的 :通过容量负荷试验评价急性心肌梗死 (AMI)溶栓再通与溶栓未通或未溶栓者早期的基础心功能及心脏储备功能的动态演变。方法 :选择 30例前壁及广泛前壁AMI患者分为溶栓再通组与溶栓未通或未溶栓组 ,在溶栓前后 2 4h内行漂浮导管连续监测及容量负荷试验 ,进行溶栓前后及组间的比较。结果 :①溶栓再通组溶栓后 4h心功能出现明显改善 ,平均肺动脉压、肺嵌压明显下降 (P <0 .0 5 ,<0 .0 1) ,心脏指数明显升高(P <0 .0 5 )。②溶栓后 6h溶栓再通组负荷试验阴性率为 72 .2 % ,至 2 4h负荷试验阴性率为 10 0 %。③基础心功能处于正常低限者 ,负荷试验后表现为负荷试验阳性。结论 :溶栓再通后 ,随着基础心功能的改善 ,心脏储备功能也逐渐得以恢复 ,心脏储备功能的恢复要晚于基础心功能的改善。ObjectiveTo assess the effect of thrombolytic therapy on cardiac function and cardiac reserve function in patients with AMI. Method:Thirty patients with anterior wall AMI were divided into successful reperfusion group A and no reperfusion group B. Hemodynamic monitoring and volume loading test were performed immediately at the time of hospital admission and 24 hours after thrombolytic treatment. Result:In group A: MPAP and PCWP at 4 hours after thrombolytic therapy were lower than that in pretreatmet (P< 0.05 ); CO and CI were higher than pretreatment (P< 0.05 ). For volume-loading test, only 5 of 18 patients in group A were demonstrated positive reaction at 6 hours after reperfusion; All patients in group A were demonstrated negative reaction at 24 hours. Conclusion:The deta shows the thrombolytic therapy significantly improves cardiac function including cardiac reserve function.

关 键 词：心肌梗死 血栓溶解疗法 心脏功能试验 AMI 血流动力学 

分 类 号：R542.22[医药卫生—心血管疾病]