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目的 :超声心动图对比观察研究急诊再灌注治疗对急性右室心肌梗塞 (RVMI)心功能及其预后的影响。方法 :临床确诊急性心肌梗塞患者 86例 ,其中 5 8例进行了冠状动脉造影。超声心动图检查平均 (6 .1±2 .6 )天。符合 WHO关于急性心肌梗塞标准 ,所有病例均合并左室下壁心肌梗塞 ,其中同时合并左室前壁和前间壁心肌梗塞 2 3例。将 86例患者分为两组 ,急诊再灌注治疗成功患者为组 A (n=2 8例 ,11例急诊 PTCA,17例急诊溶栓 ) ;常规治疗为组 B (n=5 8例 )。结果 :两组患者冠状动脉造影平均病变血管支数无明显差异 (组 A平均 1.5 7支 ,组 B平均 1.36支 )。分别计算两组左、右心室异常节段室壁运动记分 (L VWMS,RVWMS) ,组 A和组 B有显著差异 (RVWMS:4 .0± 2 .7和 4 .3± 4 .3,P<0 .0 5 ;L VWMS:8.9± 6 .1和 10 .0± 7.3,P<0 .0 5 )。右室舒张末期和收缩末期容积 (RVEDV和 RVESV) ,组 A与组 B存在显著差异性 (32 .8± 17.0和 4 2 .4± 2 6 .7;13.8± 6 .7和 2 2 .3± 17.6 ,P<0 .0 1)。右室射血分数组 A大于组 B(5 3.6± 18.1和 4 5 .6± 18.6 ,P<0 .0 1)。左心各项指标 (左室舒张末期和收缩末期容积、左室射血分数 )组 A亦明显好于组 B(P值均 <0 .0 1)。近期临床恶性并发症 ,组 A无一例发生。组 B发生率 8% ,?
Objective: To observe the effect of emergency reperfusion therapy on the cardiac function and prognosis of acute right ventricular infarction (RVMI) in echocardiography. Methods: A total of 86 patients with acute myocardial infarction were diagnosed clinically. Among them, 58 patients underwent coronary angiography. Echocardiography was (6.1 ± 2.6) days on average. Comply with the WHO standards on acute myocardial infarction, all cases were complicated by left ventricular myocardial infarction, which combined with left anterior wall and anterior myocardial infarction in 23 cases. Eighty-six patients were divided into two groups. Group A (n = 28), emergency PTCA (n = 28) and thrombolytic therapy (n = 17) were treated with emergency reperfusion. Results: There was no significant difference between the two groups in the average number of vessels in coronary angiography (group A: 1.57, group B: 1.36). Two groups of left and right ventricular abnormal wall segment scores (LWWMS, RVWMS) were calculated respectively. There were significant differences between group A and group B (RVWMS: 4.0 ± 2 .7 and 4.3 ± 4.3, P <0. 05; L VWMS: 8.9 ± 6 .1 and 10 .0 ± 7.3, P <0. 05). Right ventricular end-diastolic and end-systolic volume (RVEDV and RVESV), group A and group B were significantly different (32.8 ± 17.0 and 42.4 ± 26.7; 13.8 ± 6.7 and 22.3 ± 17.6, P <0.01). Right ventricular ejection fraction A was greater than group B (53.6 ± 18.1 and 45.5 ± 18.6, P <0.01). Left ventricular parameters (left ventricular end-diastolic and end-systolic volume, left ventricular ejection fraction) group A was also significantly better than group B (P <0.01). Recent clinical malignant complications, group A no case occurred. Group B incidence of 8%,?