论文部分内容阅读
目的 观察和评价直接经皮冠状动脉介入治疗 ( PCI)对急性前壁心肌梗死 ( AMI)合并室壁瘤形成患者左心室重构和心功能的影响。方法 对发病后 12 h以内入院的首次前壁 AMI患者行 PCI、尿激酶静脉溶栓、AMI常规治疗。所有患者均在治疗后 2周行超声心动图 ( UCG)筛查有无室壁瘤形成。入选有室壁瘤者并于 2周、12周、2 4周行 UCG检查。结果 共入选患者 76例 ,其中PCI组 2 8例 ( A组 ) ,溶栓组 2 6例 ( B组 ) ,对照组 2 2例 ( C组 )。结果显示 :( 1)治疗后 2周 ,A组左心室收缩末期容积指数( LVESVI)、左心室舒张末期容积指数 ( LVEDVI)、左心室质量指数 ( L VMI)、局部室壁运动指数 ( RWMI)低于 C组 ( P均 <0 .0 5 ) ,左心室射血分数 ( LVEF)高于 C组 [( 4 8.3 3± 4.5 6) % vs( 3 5 .3 3± 4.2 8) % ,P<0 .0 5 ] ;B组 L VESVI、LVEDVI、LVMI、RWMI低于 C组 ( P均 <0 .0 5 ) ,L VEF高于 C组 ( P<0 .0 5 ) ;A组 LVESVI、L VEDVI低于 B组 ( P均 <0 .0 5 ) ,L VEF高于 B组 ( P<0 .0 5 )。( 2 )治疗后 12周 ,A组 LVESVI、L VEDVI低于 B组 ( P均 <0 .0 5 ) ;A、B组 LVESVI、L VEDVI、L VMI、RWMI均低于 C组 ( P均<0 .0 5 ) ,L VEF均高于 C组 ( P均 <0 .0 5 )。 ( 3 )治疗后 2 4周 A组 L VESVI仍低于 B组 3 6.60
Objective To observe and evaluate the effect of direct percutaneous coronary intervention (PCI) on left ventricular remodeling and cardiac function in patients with acute anterior myocardial infarction (AMI) complicated with aneurysm. Methods The first anterior wall AMI admitted to hospital within 12 hours after onset was treated with PCI, urokinase intravenous thrombolysis and conventional AMI. All patients underwent echocardiography (UCG) screening with or without aneurysm formation 2 weeks after treatment. Ventricular aneurysm were selected and UCG examination was performed at 2 weeks, 12 weeks and 24 weeks. RESULTS: A total of 76 patients were enrolled. Among them, 28 patients in the PCI group (group A), 26 patients in the thrombolysis group (group B) and 22 patients in the control group (group C). The results showed that: (1) LVESVI, LVEDVI, L VMI, RWMI, (P <0.05), and left ventricular ejection fraction (LVEF) was higher than that in C group [(8.33 ± 4.56)% vs (35.3 ± 4.28)%, P (P0.05), L VESVI, LVEDVI, LVMI and RWMI in group B were lower than those in group C (P0.05) L VEDVI was lower than those in group B (all P <0.05), L VEF was higher than that in group B (P <0.05). (2) LVESVI and L VEDVI in group A were lower than those in group B at 12 weeks after treatment (P <0.05); LVESVI, L VEDVI, L VMI and RWMI in group A and B were lower than those in group C (P < 0. 05), L VEF were higher than those in group C (all P <0.05). (3) L VESVI in group A was still lower than group B 6.63 after 24 weeks of treatment