早期血运重建对室壁运动正常的急性非ST段抬高心肌梗死患者左心室应变的影响  

Comparison of effect of early and delayed intervention on left ventricular strain in non-ST-segment elevation myocardial infarction patients with normal wall motion

作　　者：徐茂椿[1] 沈燕[2] 陆纪德[1] 王璐[1] 贾照英 袁晓菲 齐元 许嘉鸿 刘淼[2] XU Maochun;SHEN Yan;LU Jide;WANG Lu;JIA Zhaoying;YUAN Xiaofei;QI Yuan;XU Jiahong;LIU Miao(Department of Cardiology,Shanghai Pudong New Area Gongli Hospital,Shanghai 200135,China;Department of Cardiac Echography,Shanghai Pudong New Area Gongli Hospital,Shanghai 200135,China)

机构地区：[1]上海市浦东新区公利医院心内科,上海200135 [2]上海市浦东新区公利医院心脏超声科,上海200135

出　　处：《同济大学学报（医学版）》2022年第3期344-348,共5页Journal of Tongji University(Medical Science)

基　　金：上海市浦东新区卫生健康委员会项目(PW2017A-19)。

摘　　要：目的 比较早期或延迟血运重建对室壁运动正常的急性非ST段抬高心肌梗死患者左心室收缩期应变的影响。方法 81例室壁运动正常的急性非ST段抬高心肌梗死患者随机分为早期血运重建组(early intervention group, EG组)和延迟血运重建组(delayed intervention group, DG组),同时设置40例正常对照组(normal control group, NC组)。分析患者术前、术后1个月及1年左心室收缩期圆周应变(circumferential strain, CS)、纵向应变(longitudinal strain, LS)。结果 术前与NC组比较,2组整体圆周应变率(globe circumferential strain, GCS)显著升高(P<0.01),整体纵向应变率(globe longitudinal strain, GLS)显著降低(P<0.01),2组间各应变数值无显著差异(P>0.05)。术后1个月,整体应变率中,2组GCS均较术前显著降低(P<0.01)。EG组的GLS较DG组显著增加[(-25.06±3.45)%vs(-16.54±8.56)%,P<0.01]。区域应变率中,EG组的室间隔基底段及中间段LS较DG组显著增加,差异有统计学意义(P<0.01)。术后1年的趋势与1个月相同。结论 对于室壁运动正常的急性非ST段抬高心肌梗死患者,早期血运重建能够更好地改善左室收缩期应变,有利于心功能的改善。Objective To compare the effect of early and delayed percutaneous coronary intervention(PCI) on the systolic strain of the left ventricle in acute non-ST-segment elevation myocardial infarction patients with normal ventricular wall motion. Methods Eighty-one acute non-ST-segment elevation myocardial infarction patients with normal wall motion were randomly divided into early PCI group(EG group) and delayed PCI group(DG group), and 40 healthy subjects were enrolled as control group(NC group). The left ventricular circumferential strain(CS) and longitudinal strain(LS) were analyzed before operation, 1 month and 1 year after operation. Results The LS of the left ventricle of the two groups before intervention was significantly lower than that of the NC group(P<0.01), and the CS was significantly increased(P<0.01);while there was no significant difference in the strain values between the two groups(P>0.05)). At 1 month and 1 year after operation, in the globe longitudinal strain(GLS) of the left ventricle in the EG group was significantly higher than that in the DG group(P<0.01);while there was no significant difference in globe circumferential strain(GCS) between two groups(P>0.05). In the regional strain rate, the LSs of the basal septum and the middle septum of the EG group were significantly higher than those of the DG group(P<0.01). Conclusion For acute non-ST-segment elevation myocardial infarction patients with normal ventricular wall motion, early revascularization can better improve the left ventricular systolic strain, which is beneficial to the improvement of cardiac function.

关 键 词：急性非ST段抬高心肌梗死 斑点追踪成像 左心室应变 

分 类 号：R541.4[医药卫生—心血管疾病]