延迟PCI对急性心肌梗死患者左心室重构及心脏事件的影响

目的观察延迟经皮冠状动脉支架植入术（PCI）对急性心肌梗死患者左心室重构及心脏事件的影响。方法将经药物治疗后病情稳定的急性心肌梗死患者分成延迟PCI治疗＋药物治疗组（A组）和单纯药物治疗组（B组）。在入院即刻、7d和180d采用超声心动描记术评价左心室整体功能，并进行比较。结果A组患者行PCI术后180d左心室射血分数（LVEF）及左心室舒张末期内径（LVESd）、左心室收缩末期内径（LVESd）等指标（58．49±6．65、45．20±5．15、32．04±8．55）与术后7d（51．69±5．00、47．77±3．10、37．57±5．92）相比，差异有统计学意义（P〈O．05），与B组术后180d（53．16±5．92、46．20±4．60、35．40±7．40）比较，差异均有统计学意义（均P〈0．05）；PCI术后7d两组上述指标比较，差异无统计学意义（均P〉0.05）。讨论延迟PCI有助于防止左心室重构．改善心功能，使心脏不良事件明显下降。

Effect of Delayed Percutaneous Coronary Intervention on Left Ventricular Remodeling and Cardiac Events after Acute Myocardial Infarction

Objective To evaluate effect of delayed percutaneous coronary intervention （PCI） on left ventricular（LV） remodeling and function after acute myocardial infarction （AMI）. Methods Sixty-seven patients with AMI, ineligible for primary PCI, were treated with delayed PCI plus medical therapy （group A, n=35） or only medical therapy （group B, n=32）. The LV dimension and function were evaluated by echocardiography at the moment of admission, 7 days and 180 days later. Results LV diastolic and systolic dimensions were significantly less, and LV ejection fraction was significantly higher at 180 days than at 7 days in group A, and than that in group B. No significant difference of these parameters was observed at 7 days between two groups. Conclusion Delayed PCI may be benefit to LV remodeling and function after AMI.