Tei指数及左室充盈压对STEMI急诊PCI术后左心功能与再灌注时间的相关性研究  

Correlation of Tei Index and Left Ventricular Filling Pressure to Assess Left Heart Function and Reperfusion Time after Emergency PCI for STEMI

作　　者：余开疆 谢鑫权 余琳琳 余庆耀 YU Kai-jiang;XIE Xin-quan;YU Lin-lin;YU Qing-yao(Department of Function,the Second People's Hospital of Shanwei,Yihui Foundation Hospital of Shanwei,Shanwei,Guangdong Province,516600)

机构地区：[1]广东省汕尾市第二人民医院(汕尾逸挥基金医院)功能科,516600

出　　处：《岭南急诊医学杂志》2023年第2期112-113,129,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省汕尾市科技计划项目(200803166344066)。

摘　　要：目的:探讨超声心动图的Tei指数及左心室充盈压评估急性ST段抬高型心肌梗死(STEMI)急诊经皮冠脉介入治疗(PCI)术后左室功能与再灌注时间的相关性及预后。方法:以2020年1月至2022年9月广东省汕尾市第二人民医院诊治的冠状动脉左主干90%以上狭窄或左前支单支病变闭塞,其它血管狭窄率<70%,且行急诊PCI的首次STEMI患者120例为研究对象。根据再灌注时间的不同,分为早期组(<3 h,n=42)、中期组(3⁃6 h,n=50)和晚期组(6⁃12 h,n=38),术后1周内和3周应用超声心动图检查Tei指数及左室充盈压,分析不同再灌注时间的各项心功能指标,对左心功能改善及预后的判断。结果:再灌注时间越早,左心功能受损越轻、恢复越好。早期组心功能改善情况明显优于中、晚期组。三组急诊PCI患者在术后1周内及术后3周行超声心动图检查,Tei指数、E/e′、E/Vp比值、LVEF及左房容积均有明显差异(P均<0.05)。结论:STEMI患者再灌注时间越早,患者左心功能恢复及临床预后越好。Objective:To explore the Tei index and left ventricular filling pressure in STEMI patients after emer⁃gency PCI using echocardiographic techniques to assess the correlation between the reperfusion time and the improve⁃ment of left ventricular function and the prognosis according to different reperfusion times.Methods:120 patients were enrolled from the first STEMI patients who underwent emergency PCI in the hospital with more than 90%stenosis of the left main coronary artery or occlusion of a single lesion of the left anterior branch and<70%stenosis of other vessels from Jan 2020 to Sep 2022.According to the different reperfusion times,there were divided into early group(<3 h,n=42),in⁃termediate group(3-6 h,n=50)and late group(6-12 h,n=38).The Tei index and left ventricular filling pressure were used to analyze the left ventricular function improvement and prognosis after PCI 1 week and 3 weeks.Results:The earli⁃er the time of reperfusion,the less impaired the left heart function and the better the recovery.The improvement of cardi⁃ac function in the early group was significantly better than that in the intermediate and late groups.Echocardiographic ex⁃aminations of Tei index,E/e′,E/Vp ratio,LVEF and left atrial volume were performed within 1 week after the procedure and 3 weeks after the procedure in the three groups of patients with emergency PCI,and the differences were statistically significant(all P<0.05).Conclusion:The earlier the time of reperfusion,the better the patients’left heart function re⁃covery and clinical prognosis.

关 键 词：TEI指数 STEMI 急诊PCI 再灌注时间 

分 类 号：R542.22[医药卫生—心血管疾病]