心肌梗死患者冠状动脉介入术后心功能的变化

目的评价经皮冠状动脉介入术（PCI）对心肌梗死并左心功能不全患者左心收缩功能的作用。方法62例心肌梗死并左心功能不全患者，其中急性心肌梗死32例，陈旧性心肌梗死30例。行经皮腔内冠状动脉成形术及支架植入术，术后随访3个月。超声心动图测定左室舒张末内径（LVED）、左房内径（LAD）、左室舒张末容积（LVEDV）、左室收缩末容积（LVESV）、左室射血分数（LVEF）和左室短轴缩短率（LVFS），比较治疗前后各参数的变化。结果PCI治疗后LVED、LAD、LVEDV、LVESV较治疗前均明显减少。LVEF和LVFS明显增高（P〈0．01），血运重建时间越早，心功能恢复越好。结论心肌梗死并左心功能不全患者尽早行PCI治疗，可改善心脏功能，逆转左室重构。

Effect of percutaneous coronary intervention on cardiac systolic function in patients with myocardial infarction

Objective To study the effect of percutaneous coronary intervention （PCI） on cardiac systolic function in patients with myocardial infarction over a 3 - month period. Methods Sixty - two myocardial infarction with left ventricular dysfunction, including 32 acute myocardial infarction （AMI） and 30 old myocardial infarction （OMI） were treated by percutaneous transluminal coronary angioplasty （PTCA） and stent. Three months follow -up was conducted after PCI. The left ventricular end diastolic diameter （LVEDd）, left atrial diameter （LAD）, left ventricular end diastolic volume （LVEDV）, left ventricular end systolic volume （LVESV）, left ventricular ejection fraction （LVEF）and the left ventricular fractional shortening （LVFS） ,indexes were measured by Doppler echocardiography and compared the paranheters pre - and - post PCI. Results The LVED, LAD, LVEDV, LVESV indexs were significantly reduced （ P 〈 0.01 ） after PCI than those before PCI. LVEF and LVFS indexes were increased apparently （ P 〈 0.01 ）. The earlier the revascularization of coronary artery, the better the cardiac function recovery. Conclusions The MI patients with left ventricular dysfunction should be treated with PCI as soon as possible which can improve the left ventricular systolic function apparently and impede the remodeling of the left ventricle.