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目的应用超声心动图(ECHO)分析评价急诊经皮冠状动脉介入术(PCI)及静脉溶栓治疗对急性心肌梗死(AMI)患者左心室功能的影响。方法 60例AMI患者,随机分为PCI组(30例)与溶栓组(30例),两组的内科治疗相同。应用彩色多普勒超声测定两组患者治疗后第2、4周的左室舒张末期内径(LVD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、射血分数(EF)及左室短轴缩短率(FS)的变化情况,以评价左心室功能。结果 PCI组患者治疗后第4周与第2周LVD、LVEDV、LVESV比较差异均无统计学意义(P>0.05),EF及FS比较差异均有统计学意义(P<0.05)。溶栓组患者治疗后第4周与第2周LVD、LVEDV、LVESV比较差异均有统计学意义(P<0.05);EF及FS比较差异均无统计学意义(P>0.05,);溶栓组治疗第2、4周的LVD、LVEDV、LVESV、EF及FS与PCI组比较差异均有统计学意义(P<0.05)。结论直接PCI开通梗死相关动脉,改善左室重构,提高左心室功能较静脉药物溶栓疗效显著。
Objective To evaluate the effects of percutaneous coronary intervention (PCI) and intravenous thrombolysis on left ventricular function in patients with acute myocardial infarction (AMI) by echocardiography (ECHO). Methods Sixty patients with AMI were randomly divided into PCI group (30 cases) and thrombolytic group (30 cases). The medical treatment of the two groups was the same. The left ventricular end-diastolic diameter (LVD), left ventricular end-diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and ejection fraction (EF) were measured by color Doppler ultrasonography at 2 and 4 weeks after treatment. ) And left ventricular fractional shortening (FS) changes in order to assess left ventricular function. Results There was no significant difference in LVD, LVEDV and LVESV between the 4th week and the 2nd week after PCI in the PCI group (P> 0.05). There was significant difference between the EF and the FS in the PCI group (P <0.05). There were significant differences in LVD, LVEDV and LVESV between the 4th week and the 2nd week after thrombolytic therapy (P <0.05), but there was no significant difference between EF and FS (P> 0.05) There were significant differences in LVD, LVEDV, LVESV, EF and FS between the first and second week and the PCI group (P <0.05). Conclusion Direct PCI opens infarct-related artery, improves left ventricular remodeling, and improves left ventricular function compared with intravenous drug thrombolysis.