经皮冠脉介入手术时机对急性心肌梗死后左室重构及心功能的影响

发布时间：2018-03-15 03:08

本文选题：急性心肌梗死　切入点：经皮冠脉介入术　出处：《中国老年学杂志》2016年16期 　论文类型：期刊论文

【摘要】：目的探讨经皮冠脉介入手术时机对急性心肌梗死后左室重构及心功能的影响。方法选择160例急性心肌梗死患者为研究对象,其中行直接经皮冠脉介入治疗60例(直接组),行延迟经皮冠脉介入治疗60例(延迟组),未行任何冠脉治疗40例(对照组)。急性心梗后1 w和6个月彩色多普勒超声心动图测定血流动力学的平均二尖瓣压力差(m MPG)、肺动脉平均压(m PAP),心脏彩超检测左室舒张末径(LVDEd)、左室收缩末径(LVSEd)、左房内径(LAd)等心功能指标,记录半年内的心衰再住院率。结果三组患者急性心梗后1 w的血流动力学和心功能指标比较无统计学差异(P0.05)。6个月后经皮冠脉介入患者的m MPG、m PAP均明显低于对照组,且直接组低于延迟组(P0.05)。经皮冠脉介入患者的LVDEd、LVSEd、LAd均低于对照组,且直接组优于延迟组(P0.05)。三组患者半年内的心衰再住院率分别为1.67%、5.00%和17.50%,差异有统计学意义(P0.05)。结论经皮冠脉介入可改善急性心肌梗死患者的左室重构及心功能,减少心衰再住院率,不同手术时机可以影响患者的左室重构及心功能,急性心肌梗死患者行直接经皮冠脉介入治疗效果较好。
[Abstract]:Objective to investigate the effect of percutaneous coronary intervention on left ventricular remodeling and cardiac function after acute myocardial infarction. Methods 160 patients with acute myocardial infarction were selected as subjects. 60 cases were treated with direct percutaneous coronary intervention (direct group) and 60 cases with delayed percutaneous coronary intervention (delayed group, 40 cases without any coronary artery therapy) (control group, 1 week and 6 months after acute myocardial infarction). Echocardiography was used to measure the mean mitral pressure difference (MMPG), pulmonary artery pressure (PAP), left ventricular end-diastolic diameter (LVD Edn), left ventricular end-systolic diameter (LVS Edna), left atrial diameter (LAd) and so on. Results there was no significant difference in hemodynamic and cardiac function indexes between the three groups at 1 week after acute myocardial infarction. After 6 months of percutaneous coronary intervention, the m MPG PAP of the patients was significantly lower than that of the control group. In the direct group, LVD Edn LVS Edna were significantly lower than those in the control group (P < 0.05), and LVD Edn LVS Edna were significantly lower in the patients with percutaneous coronary intervention than those in the control group. The rehospitalization rate of heart failure in the three groups was 1.675.00% and 17.50% within half a year, respectively. The difference was statistically significant (P 0.05). Conclusion Percutaneous coronary intervention can improve the left ventricular remodeling and cardiac function of patients with acute myocardial infarction, and reduce the rehospitalization rate of heart failure. Left ventricular remodeling and cardiac function can be affected by different operative timing. Direct percutaneous coronary intervention is effective in patients with acute myocardial infarction.
【作者单位】：遵义市第一人民医院心血管内科;
【分类号】：R542.22

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