摘要
目的应用超声心动图(UCG)观察急诊与延迟PCI前、后不同时期室壁运动及心功能变化,以评价其近期疗效。方法选择本院初次发病、犯罪血管为左前降支或右冠状动脉的急性心肌梗死(AMI)患者48例,按发病至PCI时间的不同分为两组,6h以内为A组共25例行急诊PCI,6h以后为B组共23例行延迟PCI。于术前、术后即刻、7d、30d、120d行超声心动图检查。结果 A组疗效显著(P<0.05),B组疗效有改善,但差异无统计学意义(P>0.05)。A组疗效优于B组。A组UCG各项观察指标(室壁运动指数WMSI、左室舒张末期容积指数EDVI、收缩末期容积指数ESVI、左室射血分数LVEF)于术后即刻、7d、30d、120d均有不同程度改善,30d改善最显著。B组30d较7d有所改善,120d较30d仍有改善,但差异均不显著(P>0.05)。结论急诊PCI能及时挽救频死心肌,控制左心室重构,改善左心室功能,疗效显著,优于延迟PCI;延迟PCI虽不能显著改善左心室功能,但可延缓左心室重构,对疗效有改善。超声心动图能方便、快捷、较准确地评价PCI疗效。
Objective To apply the ultrasonic cardiogram （UCG） in the assessment of wall motion and changes of heart function in different periods of emergency percutaneous coronary intervention （PCI） and delayed PCI, and to evaluate its short-term effect. Methods Data of 48 patients with acute myocardial infraction（AMI） were studied, the criminal vessels were left anterior descending or right coronary artery. Patients were divided into two groups according to the time from onset to PCI, 25 cases in group A treated with emergency PCI within 6h from onset, 23 cases in group B treated with delayed PCI in more than 6h from onset. Patients were monitored by UCG before operation, immediately, 7 days, 30 days, 120 days after operation. Results The patients in group A had significant curative effects, better than those in group B. In group A, the UCG indexes including left ventricular wall motion index （WMSI）, end diastolic volume index （EDVI）, end systolic volume index（ESVI）, left ventricular ejection fraction （LVEF） improved in immediately, 7 days, 30 days, 120 days, and were best in 30 days. In group B, those indexes had no significan differences between different time. Conclusion Emergency PCI can timely save dying myocardium, control the left ventricular remodeling, improve left ventricular function. Emergency PCI has a better effect than delayed PCI. Although delayed PCI couldn＇t significantly improve left ventricular function, it could delay left ventricular remodeling. UCG is convenient, fast, accurate for evaluating the efficacy of PCI.
出处
《中国医药科学》
2015年第3期18-21,共4页
China Medicine And Pharmacy
基金
广东省江门市科技计划项目(江科[2011]93号)
关键词
超声心动图
急性心肌梗死
急诊PCI
延迟PCI
左心室重构
心功能
Ultrasonic cardiogram
Acute myocardial infraction
Emergency PCI
Delay PCI
Left ventricular remodeling
Cardiac function
