超声心动图对急性心肌梗死患者应用冠状动脉远端保护装置的监测与评价

目的 应用超声心动图技术监测与评价经皮冠状动脉介入治疗(PCI)联合应用冠状动脉远端保护装置的急性心肌梗死患者局部和整体心功能的改变。方法 常规PCI对照组30例，应用远端保护装置的试验组22例，分别于术前、术后1个月、3个月行超声心动图检查，分别测量左室射血分数(EF)、室壁运动记分指数(WMSI)及左室容积。结果 试验组术前各项指标均与常规PCI组差异无显著性意义，术中均回抽出肉眼可见的红色／白色血栓。术后1个月及3个月时试验组EF值、3个月时WMSI、左室舒张及收缩末期容积与对照组差异均有显著性意义，与两组在心肌梗死溶栓血流分级改善方面一致。结论 联合使用远端保护装置，可有效改善心肌灌注，提高局部和整体心肌收缩能力。超声心动图可以观测、评价其近期和远期再灌注效果，且可进行长期监测随访。

Evaluation of heart function in patients with acute myocardial infaction using distal occlusion balloon protection device by echocardiography

Objective To evaluate left ventricle function in the patients with acute myocardial infarction(AMI) using distal occlusion balloon protection devices by echocardiography.Methods Twenty-two patients who had received percutaneous coronary intervention (PCI) with distal protection devices were examined by echocardiography before and after one and three months operation,and thirty patients who had received traditional PCI served as control group.Ejection fraction (EF),wall motion score index(WMSI),left ventricular end-diastolic volume(LVEDV),and left ventricular end-systolic volume(LVESV)was measured in each patient.Results There were no differences in each index between two groups preoperatively.Red or pale thrombi were aspirated in all the patients using distal protection devices.Compared with control group,EF and LVESV were significantly higher in the one and three months post-operative,WMSI,LVEDV and LVESV were significantly lower after three months in distal protection devices group.The same result occurred in thrombolysis in myocardial infarction flow grade between two groups.Conclusions Myocardial perfusion and systolic function were improved using distal protection devices.The effect of reperfusion could be monitored and evaluated by echocardiography.