急性心肌梗死后延迟冠状动脉介入治疗的疗效

目的评价急性心肌梗死(acute myocardial infarction,AMI)后进行延迟经皮冠状动脉介入治疗(delayed percutaneous coronary intervention,dPCI)对心肌梗死患者的治疗效果。方法dPCI组选择ST段抬高的AMI56例,各例于发病后7～14d实施dPCI,对照组为同期入院而未进行PCI治疗的ST段抬高的AMI47例。两组均常规应用药物治疗。观察住院期间和随访6个月时的主要心血管事件和超声心动图的变化。结果6个月时dPCI组左心室舒张末容积指数(left ventricular end-diastolic volumeindex,LVEDVI)、左心室收缩末期容积指数(left ventricular end-systolic volume index,LVESVI)及左心室射血分数(left ventricular ejection fraction,LVEF)、左心室室壁节段运动评分指数(left ventricular wall motion score index,WMSI)及异常室壁节段恢复率优于对照组,dPCI组总临床事件发生率低于对照组,差异有统计学意义(P<0.05)。结论dPCI可有效抑制左心室重构和改善左心室功能,可能有利于减少远期心力衰竭的发生。

Clinical assessment for the benefits of delayed percutaneous transluminal coronary intervention in patients with acute myocardial infarction

Objectives To assess the clinical effect of routine delayed percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI). Methods Fifty-six patients with ST-segment elevation myocardial infarction(SETMI)who underwent delayed PCI(PCI group) and 47 patients with STEMI who were given conservative strategy(control group) were enrolled in this study and were compared in major adverse clinical events and cardiac structure and function by echocardiography during hospitalized period and followed-up 6-month. Results During follow-up period, the left ventricular end-diastolic volumes index (LVEDVI), left ventricular end-systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), left ventricular wall motion score index (WMSI) and the total recover rate for the abnormal movement of the ventricle segments were significantly improved in the PCI group(P<0.05). The occurrence rates of adverse cardiac events in the PCI group were less than those in the control group after 6 months(P<0.05). Conclusions Delayed PCI can inhibit the late phase left ventricular remodeling and improve left ventricular function.