摘要
【目的】评价延迟经皮冠状动脉腔内成形术 (PTCA)对伴室壁瘤形成的急性心肌梗死患者左心室重构的影响。【方法】 34例初次伴室壁瘤的急性心肌梗死患者 ,于发病 2～ 3周内分别进行PTCA治疗。全部病例梗死相关血管均为完全或次全闭塞病变。经过左心室造影计算室壁瘤面积 ,梗死区室壁运动百分率 ,左心室舒张未容积指数 (EDVI) ,Cortina室壁运动不良积分和左室射血分数 (LVEF)。【结果】PTCA 6个月后 ,本组病例表现出室壁瘤面积缩小 (8 8cm2 ± 1 2cm2 vs 14 3cm2 ±1 1cm2 ) ,左心室重构导致的扩张受到了限制 (EDVI在术后无增加 ) ,左室局部及整体收缩功能明显改善 (LVEF 5 3 3%± 9 6 %vs45 4%± 10 3% ,P <0 0 1;梗死区收缩百分率 9 8%± 3 7%vs8 2 %± 4 1% ,P <0 0 5 )。Cortina室壁运动不良积分下降(8 7± 3 3vs10 8± 3 1,P <0 0 1)。【结论】伴室壁瘤的初发Q波型急性心肌梗死接受延迟的PTCA再血管化治疗可改善左心室重构 ,有益于患者左心功能的恢复。
Objective To assess the effect of late revascularization by primary percutaneous transluminal coronary angioplasty (PTCA) on left ventricular remodeling after acute myocardial infarction. Methods 34 patients with left ventricular aneurysm was performed PTCA within 2～3 weeks after acute initial Q-wave myocardial infarction. The infarct-related artery is totally or subtotally occluded in all patients. Left ventricular ejection fraction (LVEF), dyskinetic area, percent regional wall motion of infarcted wall, cortina dysfunction score, end-diastolic volume index (EDVI) and LVEF were calculated by left ventriculography. Results A second ventricular angiogram was performed 6 month after PTCA, the dyskinetic area was found to have great reduction (8.8±1.2 vs 14.3±1.1). There were significant improvement of LVEF (53.3%±9.6% vs 45.4%±10.3%, P<0.01) and the percentage of regional wall motion of infarcted wall (9.8%±3.7% vs 8.2%±4.1%, P<0.05). The Cortina dysfunction score was reduced significantly (8.7±3.3 vs 10.8±3.1, P<0.01). The EDVI remains unchanged, the ventricular dilation probably had been prevented. Conclusions In initial Q-wave myocardial infarction with left ventricular aneurysm, even with late reperfusion, PTCA had beneficial effects on left ventricular remodeling and left ventricular function.
出处
《中山医科大学学报》
CSCD
北大核心
2001年第4期283-285,共3页
Academic Journal of Sun Yat-sen University of Medical Sciences
关键词
急性心肌梗死
冠状动脉成形术
左心室功能
myocardial infarction, acute
coronary angioplasty, percutaneous, transluminal
ventricular function, left
