PPCI对急性心肌梗死后心室重构及功能的影响

目的应用实时三维超声技术(three-dimensional realtime echocardiography,RE-3D)和B型脑钠肽(type B na-triuretic peptide,BNP)测定评价急性心肌梗死(Acute myocardial infarction,AMI)患者成功行急诊经皮冠状动脉成形术(primary percutaneous coronary intervention,PPCI)后的心室重构及心功能。方法选择AMI患者12例,成功行PPCI术,评价术前和术后1周BNP水平,并分别于术后1 d、1周、1个月行应用RT-3DE对左室容积及功能进行分析评价。结果术后1周与术后1 d相比,左室舒张末期容积(left ventricular end-diastolic volume,LVEDV)和E/A比(E/A ratio)变化差异无统计学意义。左室射血分数(ejection fractional,EF),左室收缩末容积(left ventricular end-systolic volume,LVS-DV)减小,差异具有统计学意义(P<0.05)。术后1个月与术后1 d相比,上述(指标)差异均有统计学意义(P<0.05)。术后1周BNP水平较术前明显下降,差异具有统计学意义(P<0.05)。且BNP下降程度和EF升高程度呈负相关趋势。结论成功的PPCI术能够在较短时间内改善AMI患者左室重构和心功能。

Effect of Primary Percutaneous Coronary Intervention on Ventricular Remodeling and Function in AMI Patients

Objective To evaluate the role of real-time three-dimensional echocardiography(RT3DE) and brain natriuretic peptide(BNP) in the identification of ventricular remodeling of patients with acute myocardial infarction(AMI) successfully treated by primary percutaneous coronary intervention(PCI).Methods Twelve AMI patients were treated with PPCI successfully.The level of BNP was measured before PPCI and 1 week after PPCI.The examination of RT3DE was carried out in 1 day,1 week and 1 month respectively after PPCI.All index were measured by echocardiography included left ventricular ejection fraction(EF),end-diastolic volume(LVEDV),end-systolic volume(LVESV),E/A ratio.Results Comparing the value of 1 day and 1 week after PCI,the LVEDV and E/A ratio was no significantly difference;EF and LVSDV decreased and the difference was significance(P<0.05).Meanwhile,all echo indexes had significantly difference after 1 month.1 week after PCI,BNP level decreased,there was significant difference(P<0.05).A negative correlation was found between BNP decreasing and EF increasing.Conclusion The left ventricular remodeling and function of AMI patients can be improved in short time by successful PPCI.