急性心肌梗塞静脉溶栓治疗改善左心室功能的作用

为评价急性心肌梗塞（ＡＭＩ）静脉溶栓再灌注对左心室功能及重塑的影响，应用二维超声心动图（２ＤＥ）对６１例ＡＭＩ接受静脉溶栓治疗的患者，分别在急性期及６个月后随访时测量并计算左心室容积（ＥＳＶ和ＥＤＶ），射血分数（ＥＦ），左心室内膜弧长（ＡＳＬ和ＰＳＬ）以及室壁运动指数（ＧＷ－ＭＩ和ＲＷＭＩ）。结果显示，以上各项指标急性期时两组比较差异均无显著性，在６个月后的随访中，再通组ＥＦ值明显高于未通组，再通组左室容量减小、变形减轻。急性期两组的心功能无差异，随访时再通组心功能较未通组显著改善。提示溶栓再灌注能明显减轻左心室的扩张及抑制左心室重塑，改善患者的心功能和预后。

Effects of thrombolytic reperfusion on left ventricular function after acute myocardial infarction

The aim of this study was to assess the effects of reperfusion by thrombolysis on left ventricular size and function evaluated by two dimensional echocardiography (2DE). Sixty one patients with first acute myocardial infarction (AMI) receiving thrombolytic therapy were divided into reperfusion group and non reperfusion group according to the clinical characteristics. Left ventricular end diastolic volume (EDV), end systolic volume (ESV), and ejection fraction (EF) were determined by Simpson biplane formula. In the minor axis view at the level of papillary muscles, anterior and posterior endocardial segmental lengths (ASL and PSL) were measured. Global and regional wall motion score indices (GWMI and RWMI) were also analyzed. During 6 months follow up, all parameters, except EF were higher in non reperfusion group than those in reperfusion group ( P <0 01 for all). EF significantly improved during follow up in reperfusion group and was higher than that in non reperfusion group ( P <0 01). The result suggest that reperfusion with thrombolysis after acute myocardial infarction can favorably influence lefr ventricular remodeling and prevent left ventricular dilatation. It can also improve heart function.