急性非ST段抬高型心肌梗死患者介入术后左室舒张功能变化  

Changes of left ventricular diastolic function in patients with acute non-ST segment elevation myocardial infarction after intervention operation

作　　者：李丽江 蔡红雁[1] 壮可[2] 丁筱雪[2] LI Lijiang;CAI Hongyan;ZHUANG Ke;DING Xiaoxue(Department of Cardiovascular Medicine,The First Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China;Department of Cardiovascular Medicine,The 1st people's Hospital cf Yunnan,Kunming Yunnan 650034,China)

机构地区：[1]昆明医科大学第一附属医院心血管内科,云南昆明650032 [2]云南省第一人民医院心血管内科,云南昆明650034

出　　处：《云南医药》2023年第2期7-11,共5页Medicine and Pharmacy of Yunnan

基　　金：云南省高层次卫生计生技术人才培养经费项目(H-2018038);云南省科技厅-昆明医科大学联合专项面上项目(202201AY070001-257)。

摘　　要：目的观察NSTEMI患者PCI术后早期和远期左心室舒张功能的特点及变化情况。方法连续纳入2021年2月-2022年2月首次因NSTEMI在云南省第一人民医院心内科住院成功进行PCI术患者99例。入院48小时内完成首次心脏超声检查对舒张功能进行测定,术后半年返院复查超声心动图。结果半年E、A、E/A、E/e’较早期改善,早期DD程度与年龄(r=0.242,P=0.016),Killips分级(r=0.339,P=0.001),CKD(r=0.509,P<0.001),NT-pro-BNP(r=0.597,P<0.001)呈正相关,与eGFR(r=-0.469,P<0.001)呈负相关;远期DD程度与年龄(r=0.207,P=0.012),CKD(r=0.266,P=0.008),DM(r=0.215,P=0.033),NT-pro-BNP(r=0.400,P<0.001),病变血管数(r=0.228,P=0.023)呈正相关;多重线性分析中年龄、CKD及早期LVEDD是远期E/e’的独立影响因子。结论NSTEMI患者远期舒张功能指标E、E/A、E/e’较早期改善,年龄、CKD和早期LVEDD是远期舒张指标E/e’的独立影响因子。Objective To observe the characteristic and changes of left ventricular diastolic function in patients with acute non-ST segment elevation myocardial infarction(NSTEMI)at early and long stage after percutaneous coronary intervention(PCI).Methods 99 NSTEMI patients with successful PCI for the first time in the Department of Cardiovascular Medicine of the 1 st People's Hospital of Yunnan from Feb.2021 to Feb.2022.The first echocardiography was completed within 48 hours to determine diastolic function,and returned to the hospital for the echocardiograph reexamination 6 months after PCI.Results E,A,E/A and E/e'were improved after 6 months compared those in early stage.The severity of diastolic dysfunction(DD)at early stage was related positively with age(r=0.242,P=0.016),Killips(r=0.339,P=0.001),chronic kidney disease(CKD)(r=0.509,P<0.001),and NT-pro-BNP(r=0.597,P<0.001),it was related negatively with eGFR(r=-0.469,P<0.001);DD of long-term was related positively with age(r=0.207,P=0.012),CKD(r=0.266,P=0.008),DM(r=0.215,P=0.033),NT-pro-BNP(r=0.400,P<0.001),and number of diseased vessels(r=0.228,P=0.023).Multiple linear regression analysis showed that age,CKD and early-stage LVEDD were independent influence factors for long-term E/e'.Conclusions Diastolic function indexes of E、E/A、E/e'in NSTEMI patients are improved compared with early stage after PCI,age,CKD and early-stage LVEDD are independent influence factors of long-term E/e.

关 键 词：急性非ST段抬高型心肌梗死 超声心动图 左心室 舒张功能 

分 类 号：R542.22[医药卫生—心血管疾病]