不同时段介入治疗对心肌梗死患者心室收缩同步性的影响  

Influence of interventional therapy in different time intervals on ventricular systolic synchronicity in patients with myocardial infarction

作　　者：毕云[1] 郭贤利[2] 毛艳阳[1] 

机构地区：[1]延安大学附属医院东关心脑血管专科病区心内科四病区,延安716000 [2]延安大学医学院,延安716000

出　　处：《中国循证心血管医学杂志》2016年第1期50-53,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨不同时段介入治疗对心肌梗死患者心室收缩同步性的影响。方法选择2013年1月-2015年1月于延安大学附属医院东关心脑科室收治的心肌梗死患者92例,男性47例,女性45例。随机分为治疗组与对照组,各46例。术前均给予抗凝治疗。对照组给予急诊经皮冠状动脉介入治疗（发病到介入治疗〈12 h）。治疗组给予择期经皮冠状动脉介入治疗（发病到介入治疗≥12 h）。结果与对照组介入治疗后比较,治疗组左室收缩末期容积指数（LVESVI）和左室舒张末期容积指数（LVEDVI）均降低,左室射血分数（LVEF）升高,数值为[（33.98±4.56）ml/m2 vs.（24.09±5.09）ml/m2]、[（61.93±6.33）ml/m2 vs.（54.98±5.91）ml/m2]、[（51.94±5.55）%vs.（58.29±5.13）%],差异有统计学意义（P均〈0.05）。介入后治疗组的Trs-Avg-12值明显低于对照组[（400.33±26.55）s vs.（420.10±20.31）s],差异有统计学意义（P〈0.05）。治疗组主要不良心血管事件发生率为10.9%,对照组为41.3%,治疗组明显少于对照组,差异有统计学意义（P〈0.05）。结论相对于急诊经皮冠状动脉介入术,择期经皮冠状动脉介入术治疗心肌梗死患者能在保持成功率的基础上,改善心功能,促进恢复心室收缩同步性,安全性较好。Objective To investigate the influence of interventional therapy in different time intervals on ventricular systolic synchronicity in patients with myocardial infarction. Methods The patients （n=92, male 47 and female 45） were chosen from Jan. 2013 to Jan. 2015, and then randomly divided into treatment group and control group （each n=46）. All groups were given anticoagulation therapy, and control group was given emergency percutaneous coronary intervention （PCI, duration from disease attack to PCI〈12 h ） ） and treatment group was given delayed PCI （duration from disease attack to PCI〈12 h）. Results After treatment, LVESVI [（33.98±4.56） mL/m2 vs. （24.09±5.09） mL/m2] and LVEDVI [（61.93±6.33） mL/m2 vs. （54.98 ±5.91） mL/m2] decreased, LVEF [（51.94 ±5.55）% vs. （58.29±5.13）%] increased in treatment group compared with control group （all P〈0.05）. After treatment, Trs-Avg-12 was significantly lower in treatment group than that in control group [（400.33± 26.55） s vs. （420.10±20.31） s, P〈0.05]. The incidence of major adverse cardiovascular and eerebrovascular events was 10.9% in treatment group and 41.3% in control group （P〈0.05）. Conclusion The delayed PCI can improve heart function and recovery of ventricular systolic synehronicity with higher safety besides of maintaining success rate compared with emergency PCI.

关 键 词：心室收缩同步性 心肌梗死 介入治疗 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]