直接与延迟PCI对急性心肌梗死后左室重构及心功能的影响与比较  

The comparison of effect on left ventricular remodeling and heart function between primary and delayed PCI in patients with acute myocardial infarction

作　　者：刘胜强[1] 娄闯[1] 袁博[2] 任晖[2] 

机构地区：[1]陕西省安康市中医院心内科,安康725000 [2]陕西省安康市中心医院心内科

出　　处：《陕西医学杂志》2015年第3期300-302,共3页Shaanxi Medical Journal

摘　　要：目的:探讨比较直接与延迟经皮冠脉介入术(PCI)对急性心肌梗死(AMI)后左室重构及心功能的影响。方法:收集资料完整的AMI患者115例,其中行直接PCI治疗40例,行延迟PCI治疗37例,未行任何冠脉再灌注治疗(包括静脉溶栓或PCI术)38例(对照组)。观察所有患者急性心梗后1周、6个月随访时的心脏超声资料及半年内因心衰住院事件,比较分析三组患者左室舒张末容积指数(LVEDVI)、左室收缩末容积指数(LVESVI)及左室射血分数(LVEF)及半年内的心衰再住院率。结果:AMI后行PCI治疗组LVEDVI、LVESVI及LVEF明显好于未行任何冠脉再灌注治疗的对照组患者,并且行直接PCI治疗组LVEDVI、LVESVI及LVEF好于行延迟PCI治疗组患者;PCI治疗组心衰再住院率1.3%明显低于对照组13.2%,差异均有统计学意义。结论:直接与延迟PCI都可以改善急性心梗患者左室重构及心功能,尤以行直接PCI更为显著。Objective：To investigate and compare the effect between primary and delayed PCI on left ventricular remodeling and heart function in patients with acute myocardial infarction（AMI）.Methods：one hundred and fifteen patients with AMI were divided into primary PCI group（n=40）and delayed PCI group（n=37）and control group without receiving any coronary artery reperfusion（n=38）.Left ventricular end-diastolic volume index（LVEDVI）,left ventricular end-systolic volume index（LVESVI）and left ventricular ejection fraction（LVEF）were measured at an average of 7days and 6months after AMI and Heart failure events in each group were followed up.Results：There were significant differences in receiving PCI group and control group for LVEDVI and LVESVI and LVEF,PCI group were better than control group and primary PCI group were more significant than delayed PCI group.The heart failure events in PCI group were less than control group（13.2% vs 1.3%）.Conclusions：Both primary and delayed PCI therapy can effectively prevent left ventricular remodeling and improve heart function in patients with AMI and primary PCI is more significant.

关 键 词：经皮冠状动脉介入治疗/方法 心肌梗塞/治疗 左室复建 心室功能障碍 

分 类 号：R542.2[医药卫生—心血管疾病]