摘要
目的 应用压力导丝 ,通过冠状动脉内压力测定 ,评价急性心肌梗死 (AMI)患者侧支血流分数 (QC QN)与左室重塑的关系。方法 2 1例AMI患者 ,于经皮腔内冠状动脉成形术 (PTCA)时 ,对梗死相关动脉远端侧支血流行Rentrop分级并记录梗死相关动脉病变远端嵌楔压 (Pw)及主动脉压(Pa) ,据QC QN 值将 2 1例患者分为A组 (QC QN ≥ 0 .2 5 ) ,B组 (QC QN <0 .2 5 )。所有患者于AMI后 3d和 1个月行二维超声心动图检查 ,并进行统计学分析。结果 AMI后 3dA、B两组间EF分别为 (5 1 7± 7 1) %和 (45 6± 5 8) %(P <0 0 5 ) ;ESVI分别为 (2 5 0± 5 4 )ml m2 和 (30 5± 6 2 )ml m2 (P <0 0 5 ) ;EDVI分别为 (5 1 9± 9 8)ml m2 和 (5 5 4± 7 5 )ml m2 (P >0 0 5 )。AMI后 1个月 ,两组间EF分别为 (5 3 7± 7 1) %和 (43 9± 8 1) %(P <0 0 1) ;ESVI分别为 (2 7 1± 5 8)ml m2 和 (38 7± 11 5 )ml m2(P <0 0 1) ;EDVI分别为 (5 8 3± 7 5 )ml m2 和 (6 7 8± 13 0 )ml m2 (P <0 0 5 )。AMI后 1个月较 3d ,A组患者EF有明显改善 (P <0 0 5 ) ,B组EF变化不明显 (P >0 0 5 ) ;A、B两组患者ESVI和EDVI均有显著增大。结论 造影Rentrop分级对侧支循环的评价存在局限性 ;
Objective To evaluate the relationship between pressure derived fractional collateral flow (Q C/Q N) and left ventricular remodeling after acute myocardial infarction(AMI) Methods The Q C/Q N was measured in 21 patients with first AMI treated with percutaneous transluminal coronary angioplasty (PTCA), being determined by simultaneous measurement of mean aorta pressure (P a), distal coronary pressure (P w) during the balloon occlusion 21 patients were divided into two groups according to the value of Q C/Q N (group A, Q C/Q N≥0 25, group B, Q C/Q N<0 25) Angiographic collateral vessels (0 to 3) were graded according to Rentrop′s classification All patients underwent echocardiographic examination on day 3 and day 30 after AMI and statistical analysis was done Results Day 3 after AMI, left ventricular ejection fraction(EF), left ventricular end systolic volume index (ESVI) were significantly different between the two groups( P <0 05) However, left ventricular end diastolic volume index (EDVI)was similar between the two groups ( P >0 05) At one month follow up, the difference in EF ( P <0 01), ESVI( P <0 01) and EDVI( P <0 05) were considerably larger than that of day 3 between the two groups At one month, EF was higher than day 3 in group A ( P <0 05), however, with respect to EF in group B there is no significant difference at these two different time point( P >0 05) Both ESVI and EDVI were considerably increased in two groups Conclusion Angiographic Rentrop′s classification has its limitation in assessing the collateral circulation Q C/Q N is a major determinant of left ventricular remodeling and prognosis in patients with AMI
出处
《中国介入心脏病学杂志》
2002年第4期197-200,共4页
Chinese Journal of Interventional Cardiology
