介入治疗时间对急性心肌梗死左心功能的影响.docVIP

介入治疗时间对急性心肌梗死左心功能的影响 　　作者：甘剑挺，李平，姚光，王正东 作者单位：(广西玉林市人民医院，广西医科大学第六附属医院心内科，广西?玉林?537000 E-mail：ganjianting333@163.com) 　　【摘要】 目的 探讨不同介入治疗时间对急性ST段抬高型心肌梗死(STEMI)左心功能的影响。方法 将102例STEMI施行冠状动脉介入治疗(PCI)患者根据发病到开始PCI的时间分为两组，12h内为直接介入组(n=49)，以及5～10天为择期介入组(n=53)。比较两组术后心肌梗死溶栓试验(TIMI)血流，以及PCI后3天内、1个月、6个月分别行超声心动图检查，观察左心室收缩末容积指数(LVESVI)、左心室舒张末容积指数(LVEDVI)和左室射血分数(LVEF)，并判断左心功能的状况。结果 两组患者术前基本临床情况以及术中情况差异无显著性。两组在术后3天内左心功能差异无显著性，两组患者术后1、6个月左心功能均有改善，直接介入组左心功能改善程度明显优于择期介入组。结论 直接以及择期介入治疗均能改善STEMI患者左心功能，而直接介入治疗相对效果更显著。 　　【关键词】 心肌梗死;放射摄影术，介入性;治疗时间;心室功能，左 　　The influence of door-to-ballon time on left cardiac function 　　in myocardial infarction 　　GAN Jian-ting, LI Ping, YAO Guang, WANG Zheng-dong 　　(Yulin Peoples Hospital of Guangxi Province, Cardiovascular Department, the Sixth Affiliated Hospital 　　to Guangxi Medical University, Yulin, Guangxi 537000, China E-mail:ganjianting333@163.com) 　　Abstract: Objective To evaluate the influence of door-to-balloon time on the left cardiac function in patients with acute ST-elevation myocardial infarction (STEMI). Methods 102 consecutive patients with STEMI were recruited. Patients underwent percutaneous coronary intervention (PCI). According to the door to-ballon time，the direct PCI group consisting of 49 recruited patients underwent PCI within 12 hours，whereas the selective PCI group comprising 53 registered cases underwent PCI on day 5～10. Compared of post-operative TIMI blood flow between the two groups. The LVESVI, LVEDVI and LVEF were determined by echocardiogram 72 hours, 1 month and 6 months after PCI. Left cardiac function were evaluated by these data. Results Compared the direct PCI group to the selective PCI group: there were no significant differences in baseline condition of pre-operation and during operation, there was also no significant difference in left cardiac function 3 days after PCI. However，1 month and 6 months after PCI the left cardial function in both groups were improved, the direct PCI group y