实时三维超声心动图对行急诊PCI的左心室室壁瘤患者短期疗效的评估  

Evaluation of real-time three-dimensional echocardiography on short term curative effect of emergency percutaneous coronary intervention in patients with left ventricular aneurysm

作　　者：张明珠 张璐[2] 任凤霞[2] 刘天蕊[2] 邓爱云[2] 

机构地区：[1]山西师范大学医院超声室,山西临汾041000 [2]兰州大学第一医院心内科,甘肃兰州730000

出　　处：《重庆医学》2018年第5期650-653,共4页Chongqing medicine

摘　　要：目的利用实时三维超声心动图(RT-3DE)对行急诊冠状动脉介入治疗(PCI)的左心室室壁瘤(LVA)患者术前及术后2个月的心功能相关指标进行比较,评估急诊PCI短期疗效。方法应用RT-3DE观察31例急性前壁心肌梗死(AAMI)并LVA患者术前、术后2个月的左心室舒张末期容积(LVEDV)、收缩末期容积(ESV)、心排血量(CO)、舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)、心脏指数(CI)、左心室射血分数(LVEF)及左心室球形指数(SPI)。将31例AAMI患者分为功能性LVA(A组)、解剖性LVA(B组)及伴有血栓性LVA(C组)。对各组患者心功能参数进行组内及组间比较。结果与术前比较,A组术后2个月的LVEF提高,SPI降低(P<0.01);B组术后2个月的CO、CI、LVEF提高,SPI降低(P<0.05);C组术后2个月SPI下降(P<0.05);3组患者组间术前及术后2个月EF及SPI比较,差异无统计学意义(P>0.05)。术前及术后2个月的SPI与LVEF呈负相关,与EDV、ESV、EDVI、ESVI、CO、CI呈正相关。结论功能性和解剖性LVA患者PCI术后2个月左心室形态及整体收缩功能改善,伴有血栓性LVA术后2个月疗效不明显。Objective To usereal-time three-dimensional echocardiography（RT-3DE） to compare the cardiac function related in.dicators between before operation and at postoperative 2 months in the patients with left ventricular aneurysm（LVA） undergoing emergency percutaneous coronary intervention（PCI）,and to assess the PCI short term effect. Methods RT-3DE was applied to ob- serve the left ventricular end-diastolic volume（LVEDV）,end systolic volume（LVESV）, cardiac output（CO）, end-diastolic volume index（EDVI） ,end systolic volume index（ESVI）, cardiac index（CI）, left ventricular ejection fraction（LVEF） and left ventricular spherical index（SPI） before operation and at postoperative 2 months in 31 cases of acute anterior myocardial infarction（AAMI） complicating LVA. The patients were divided into the functional LVA group （A）, anatomical LVA group （B） and complicating thrombus LVA group（C）. The cardiac function parameters in various groups conducted the intra-group and inter -group compari- sons. Results Compared with before operation,LVEF at postoperative 2 months in the group A was increased and SPI was de- creased（P〈0.05）;,CO,CI and LVEF before operation and at postoperative 2 months in the group B were increased and SPI was de- creased（P〈0.05）;SPI at postoperative 2 months in the group C was decreased（P〈0.05）;EF and SPI before operation and at postoperative 2 months had no statistical difference among 3 groups（P〈0.05）. SPI before operation and at postoperative 2 months was negatively correlated with LVEF and positively correlated with EDV,ESV,EDVI,ESVI,CO and CI. Conclusion The left ven- tricular morphology and overall systolic function at 2 months after PCI in the patients with functional and anatomical LVA are im- proved,but the curative effect in the patients with complicating thrombus LVA is unobvious.

关 键 词：实时三维超声心动图 左心室室壁瘤 左心室功能 球形指数 冠状动脉介入治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学]