直接经皮冠状动脉介入治疗对急性心肌梗死患者室壁瘤的阻抑效应和心功能改善作用

目的:研究经皮冠状动脉介入治疗(PCI)对急性心肌梗死(AMI)患者室壁瘤形成的阻抑效应及心功能改善作用。方法:发病12h以内急性前壁心肌梗死伴室壁瘤形成患者随机分为直接PCI(A组36例),溶栓治疗(B组:31例),常规药物治疗(C组31例);各组患者均在治疗后1周、24周分别行超声心动图和平衡法核素心室造影评价左室质量指数(LVMI)和局部室壁运动积分(RWMI)、心室收缩同步性(VSS)和心功能(HF)等参数的改善状况。结果:治疗后1周和24周时,A组RWMI、VSS和HF均优于B组和C组,均P<0.05。A组和B组24周时上述各参数均优于1周。C组VSS参数中相角程在24周时较1周有所改善,余各项结果比较差异无统计学意义。结论:PCI治疗和溶栓对AMI患者室壁瘤有阻抑作用且改善心功能,而直接PCI优于溶栓治疗。

The reversion and improvement of heart function in the patients with left ventricular aneurysm following acute myocardial infarction by early reperfusion

Objective:To study the reversion of aneurysm and improvement of cardiac function in patients with left ventricular aneurysm following acute myocardial infarction by primary percutaneous coronary intervention (PCI ). Method:The patients with left ventricular aneurysm following acute myocardial infarction within 12 hours were divided into three groups: percutaneous coronary intervention (PCI ) group(A group), thrombolytic therapy (B group)and routine therapy group(C group). Echocardiagraphy and equilibrium radionuclide angiography (ERNA) were performed to evaluate the left ventricular mass index,region wall movement index,ventricular systolic synchrony (VSS)and heart function 1 and 24 weeks after treatment. Result:Region wall movement index, ventricular systolic synchrony and heart function parameters in A group were better than those in B and C group.The parameters in A group and B group at 24 week were better than those at 1 week. There were no difference in those parameters between 1 week and 24 week in C group except PS. Conclusion:Both percutaneous coronary intervention (PCI ) and thrombolytic therapy can reverse the formation of aneurysm and improve the cardiac function in patients with left ventricular aneurysm following acute myocardial infarction,and the former therapy is better than the latter therapy.