超声评价急诊PCI治疗STEMI患者左室舒张功能变化的临床研究  

Study on Ultrasonography in Evaluation of Changes in Left Ventricular Diastolic Function after Emergent PCI in STEMI Patients

作　　者：杨渝[1] 吴玉[2] 

机构地区：[1]四川省安岳县人民医院,四川安岳642350 [2]广西医科大学第一附属医院超声科,广西南宁530021

出　　处：《河北医学》2016年第5期747-750,共4页Hebei Medicine

基　　金：广西科技厅科技攻关项目(编号:桂科攻0719006-2-2)

摘　　要：目的:探讨急诊经皮冠状动脉内介入术(PCI)治疗对ST段抬高型心肌梗死(STEMI)患者左室舒张功能的影响,分析二尖瓣口血流舒张早期血流速度与组织多普勒运动速度比(E/E')评价STEMI患者左室舒张功能的价值。方法:收集30例STEMI患者行急诊PCI治疗术前、术后即刻、术后两周及术后两月超声心动图资料,以及急诊PCI术前、术后即刻左室舒张末压力(LVEDP)。结果:STEMI患者急诊PCI术后即刻、术后两周及术后两月与术前相比,左心室射血分数(LVEF)增高、侧壁E'减低,差异均有显著性(P<0.05):PCI术后即刻E与术前相比减低,差异有统计学意义(P<0.05);术后两周、术后两月与术后即刻、术前相比,左心房容积指数(LAVI)增大,差异有统计学意义(P<0.05)。STEMI患者二尖瓣环非梗死区的E/E'与急诊PCI术前所测的LVEDP无相关性(P>0.05),与急诊PCI术后即刻所测LVEDP无相关性(P>0.05)。结论:STEMI患者左室舒张功能在急诊PCI术后两周有减低趋势,LAVI在术后两周、两个月显著增大,E/E'与LVEDP关系尚不确切。Objective：To investigate the effect of emergent percutaneous coronary intervention（PCI）on the left ventricular diastolic function in patients with ST elevation myocardial infarction（STEMI）,to analyze the ratio of the blood flow velocity in the early diastolic period in the mitral orifice to the velocity of movement of tissue doppler imaging（E/E＇）,and to evaluate the values of left ventricular diastolic function in STEMI patients.Methods：The echocardiogram data before,just after surgery,at 2 weeks after,and at 2 months after emergent PCI,and the left ventricular end-diastolic pressure（LVEDP） before and just after the emergent PCI in 30 STEMI patients were collected.Results：STEMI patients had significantly increased left ventricular ejection fraction（LVEF） and significantly decreased E on the lateral wall just after,after 2 weeks,and after 2 months,the emergent PCI when compared with that before the surgery（all P〈 0.05）;they had significantly decreased E just after PCI when compared with that before PCI（P 〈0.05）;and they had significantly increased left atrial volume index（LAVI） at 2 weeks and 2 months after PCI when compared with that just after and before PCI（P〈 0.05）.The E/E＇ of the non- infarction zone in the mitral ring in the STEMI patients was insignificantly dependent on LVEDP determined before and just after the emergent PCI（both P〉0.05）.Conlcusion：The STEMI patients have decreased left ventricular diastolic function at 2 weeks after emergent PCI,and significantly increased LAVI at 2 weeks and 2 months after the surgery.The relationship between E/E＇ and LVEDP is not clear yet.

关 键 词：多普勒超声心动图 经皮冠状动脉内介入术 心室舒张功能 左室舒张末压 

分 类 号：R540.45[医药卫生—心血管疾病] R542.22[医药卫生—内科学]