STEMI患者PCI术后左心室GLS、梗死面积变化及与主要不良心血管事件的关系

发布时间：2018-04-24 01:25

  本文选题：心肌梗死 + 梗死面积　； 参考：《山东医药》2017年27期

【摘要】：目的观察急性ST段抬高型心肌梗死(STEMI)患者介入治疗(PCI)后6个月左心室整体纵向应变(GLS)及心肌梗死面积(IS)的变化,并探讨二者与PCI术后6~12个月主要不良心血管事件(MACE)发生情况的关系。方法选择60例PCI术后STEMI患者(其中7例PCI术后6~12个月发生MACE)。PCI术后7 d、6个月分别采用二维超声心动图斑点追踪成像技术测算左心室GLS,采用延迟增强心磁共振技术测算左心室IS。结果本组患者PCI术后7 d、6个月左心室GLS分别为-14%±3%、-17%±3%,IS分别为23%±7%、19%±6%。本组患者PCI术后6个月左心室GLS、IS均低于术后7 d,P均0.05。相关性分析显示,本组患者PCI术后左心室GLS和IS呈负相关(r=-0.756,P0.01)。本组患者PCI术后6个月左心室GLS较术后7 d降低2%~4%,中位数为3%。以PCI术后6个月左心室GLS较术后7 d降低幅度的中位数为界值将本组患者分为GLS明显降低组(降低幅度≥中位数)26例和GLS无明显降低组(降低幅度中位数)34例,其中分别有0、7例患者随访过程中发生MACE,两组MACE发生率相比,P0.05。本组患者PCI术后6个月IS较术后7 d降低2%~5%,中位数为3%。以PCI术后6个月IS较术后7 d降低幅度的中位数为界值将本组患者分为IS明显降低组(降低幅度≥中位数)21例和IS无明显降低组(降低幅度中位数)39例,其中分别有0、7例患者随访过程中发生MACE,两组MACE发生率相比,P0.05。结论 STEMI患者PCI术后6个月左心室GLS和IS低于术后7 d;STEMI患者PCI术后左心室GLS、IS有较好的相关性;STEMI患者PCI术后左心室GLS、IS明显降低者不易发生MACE。
[Abstract]:Objective to observe the changes of left ventricular global longitudinal strain (GLS) and myocardial infarction area (ISI) in patients with acute ST-segment elevation myocardial infarction (STEMI) 6 months after PCI. To explore the relationship between the two factors and the occurrence of major adverse cardiovascular events in 6 ~ 12 months after PCI. Methods A total of 60 patients with STEMI after PCI (7 patients with PCI 6 ~ 12 months after MACE).PCI) were selected to measure the left ventricular GLSs by two dimensional echocardiographic dot-tracing imaging and delayed enhanced cardiac magnetic resonance imaging at 6 months. Results on the 7th day and 6th month after PCI, the GLS of left ventricle was -14% 卤3% and 17% 卤3%, respectively. The GLS of left ventricle was 23% 卤7% 卤6%. The GLSI is of left ventricle in 6 months after PCI was lower than that in 7 days after PCI (P < 0.05). Correlation analysis showed that there was a negative correlation between left ventricular GLS and is after PCI. The left ventricular GLS at 6 months after PCI was significantly lower than that at 7 days after PCI, with a median of 3. At 6 months after PCI, left ventricular GLS was divided into two groups: GLS decreased significantly (n = 26) and GLS was not significantly decreased (n = 34). Among them, there were 7 cases of MACEE during follow-up. The incidence of MACE in the two groups was higher than that in the control group (P 0.05). The is of 6 months after PCI was 2 and 5 lower than that of 7 days after PCI, with a median of 3. According to the median value of the decrease of is at 6 months after PCI compared with that on the 7th day after PCI, the patients were divided into two groups: 21 patients with significant reduction of is (reduction 鈮，

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