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目的 应用经静脉心肌声学造影研究心肌梗死前心绞痛与心肌微循环、左心室重构和收缩功能的关系。方法 5 0例急性心肌梗死患者 ,根据梗死前 1周内有无心绞痛分成心绞痛组 (A组 ,2 7例 )与无心绞痛组(B组 ,2 3例 ) ,均进行超声检查和经静脉心肌声学造影显像。所有研究对象均进行了血管重建术 ,并于术后第 5周复查二维超声。结果 ①A组出现术后无再流现象的患者明显低于B组 (P <0 .0 0 1) ;②A、B两组的左心室舒张末期内径 (EDD)在术后第 1周差异无显著性意义 (P >0 .0 5 ) ,而在第 5周差异有显著性意义 (P <0 .0 5 ) ,A组的EDD逐渐减小 (P <0 .0 5 ) ,而B组的EDD差异无显著性意义 (P >0 .0 5 )。③A组的射血分数显著改善 ,而B组的射血分数差异无显著性意义 (P >0 .0 5 )。结论 心肌梗死前心绞痛有利于血管重建术后心肌微循环和左心室重构的改善 ,有助于左心室功能的恢复。
Objective To study the relationship between myocardial infarction pre-infarction angina and myocardial microcirculation, left ventricular remodeling and systolic function using intravenous myocardial contrast echocardiography. Methods Fifty patients with acute myocardial infarction were divided into angina pectoris group (group A, n = 27) and no angina pectoris group (group B, n = 23) within one week before infarction. All patients underwent ultrasonography and venous myocardium Acoustic imaging. All subjects underwent revascularization and two-dimensional ultrasound was reviewed at week 5 postoperatively. Results ① There was no post-operative reflux in group A compared with group B (P <0.01); ② The left ventricular end-diastolic diameter (EDD) in group A and B had no significant difference at the first week after operation (P <0.05), but there was a significant difference at the fifth week (P <0.05). EDD of group A decreased gradually (P <0.05), while group B EDD difference was not significant (P> 0.05). ③ The ejection fraction of A group was significantly improved, while the ejection fraction of B group had no significant difference (P> 0.05). Conclusions Preinfarction angina pectoris is beneficial to the improvement of myocardial microcirculation and left ventricular remodeling after revascularization and contributes to the recovery of left ventricular function.