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目的 探讨Q波型前壁心肌梗死恢复期开通梗死相关冠状动脉对左室重构 (LVRM )及心功能的影响。方法 选择 4 0例近期首次发生过Q波型前壁心肌梗死且造影显示供血区供血冠状动脉闭塞者作为研究对象 ,按前瞻性随机方式分组 ,治疗组患者心肌梗死后 4周内行冠状动脉内支架置入术 ;对照组患者心肌梗死后不作支架术。均于梗死后 4周和 2 4周进行超声心动图观察。分别测定左室舒张末期容量(LVEDV)、左室收缩末期容量 (LVESV)、左室射血分数 (LVEF)。结果 心肌梗死后均可发生明显左室重构 ;治疗组 2 4周与 4周时对比 ,LVEDV与LVESV均减小 (P <0 .0 5 ) ,而LVEF升高 (P <0 .0 5 ) ,LVRM与心功能明显改善 ,治疗组 2 4周时与对照组比较 ,以上指标有显著性差异 (P <0 .0 5 ) ;对照组 2 4周与梗死后 4周比较无显著性差异 (P >0 .0 5 )。结论 晚期恢复梗死相关动脉可明显减轻或逆转Q波型前壁心肌梗死患者的LVRM ,明显改善左心室功能。
Objective To investigate the effect of opening infarct-related coronary arteries on left ventricular remodeling (LVRM) and cardiac function in Q-wave anterior wall myocardial infarction. Methods Forty patients with Q-wave anterior myocardial infarction who had been diagnosed by Q-wave anterior myocardial infarction for the first time were enrolled in this study. Patients were randomly divided into three groups: coronary stents The patients in control group were not stenting after myocardial infarction. Echocardiography was performed at 4 weeks and 24 weeks after infarction. Left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured. Results Significant left ventricular remodeling occurred after myocardial infarction. LVEDV and LVESV both decreased (P <0.05) and LVEF increased (P <0.05) at 24 weeks and 4 weeks after treatment ), LVRM and cardiac function were significantly improved in the treatment group 24 weeks compared with the control group, the above indicators were significantly different (P <0. 05); control group 24 weeks and 4 weeks after infarction no significant difference (P> 0.05). Conclusion The recovery of infarct-related arteries in late stage can significantly reduce or reverse LVRM in patients with Q-wave anterior myocardial infarction, and significantly improve left ventricular function.