论文部分内容阅读
目的 探讨急性心肌梗死 (AMI)患者接受直接经皮冠状动脉腔内成形术 (PTCA)治疗后左室收缩功能及梗死区室壁运动恢复与心电图抬高ST下降幅度的关系。方法 接受直接PTCA的AMI患者共 34例 ,比较PTCA前及术后 1h 12导联心电图抬高ST段的总和 ,按ST段下降幅度分为两组 :A组 :ST段下降≥ 5 0 % ;B组 :ST段下降 <5 0 %。所有患者于发病第 (7± 2 )d行小剂量多巴酚丁胺超声心动图负荷试验并于发病第 1、2、3个月行超声心动图检查。结果 AMI发病急性期基础状态和负荷状态及发病后第 1、2、3个月左室射血分数 (LVEF)A组均明显大于B组 (6 3 4vs 5 6 7;6 8 9vs6 0 5 ;6 0 1vs5 3 1;6 1 4vs 5 3 1;6 0 9vs 5 2 3 ;P均 <0 0 5 )。基础状态和多巴酚丁胺负荷状态下总室壁运动积分指数 (GWMSI)和梗死区室壁运动积分指数 (IWMSI)A组均明显小于B组。AMI发病第 1、2、3个月GWMSIA组均明显小于B组 (1 2 1vs 1 38,P =0 0 42 ;1 17vs 1 38,P =0 0 15 ;1 18vs 1 30 ,P =0 0 35 )。发病第 1、2个月IWMST两组间无统计学差异。发病第 3个月IWMSTA组明显小于B组(2 16vs 2 47,P =0 0 48)。结论 急性心肌梗死直接PTCA后心电图ST段下降幅度≥ 5 0 %组在AMI急性期和恢复期左室收缩功能及梗死区室壁运动的恢复均明显优于S
Objective To investigate the relationship between left ventricular systolic function (RVF) and recovery of ventricular wall (RV) in acute myocardial infarction (AMI) patients treated with direct percutaneous transluminal coronary angioplasty (PTCA). Methods A total of 34 patients with AMI receiving direct PTCA were enrolled in this study. The total electrocardiographic (ST) elevation before and 12 hours after PTCA was compared and divided into two groups according to the decrease of ST segment: group A: the ST segment decreased ≥ 50%; Group B: ST segment decreased <50%. All patients in the incidence of (7 ± 2) d low-dose dobutamine stress echocardiography load test and the onset of 1, 2, 3 months underwent echocardiography. Results The basal state and load status of acute phase of AMI and the incidence of left ventricular ejection fraction (LVEF) at 1, 2 and 3 months after onset were significantly higher in group A than those in group B (6 3 4 vs 5 6 7; 6 8 9 vs 6 0 5; 6 0 1vs5 3 1; 6 1 4vs 5 3 1; 6 0 9vs 5 2 3; P <0 05). Basement and dobutamine stress conditions, total wall motion integral index (GWMSI) and infarction area wall motion integral index (IWMSI) A group were significantly less than the B group. The incidence of AMI in GWMSIA group was significantly lower than that in group B at 1, 2, and 3 months (P <0.001) 35). There was no significant difference between the two groups in IWMST at the first and second months after onset. The incidence of IWMSTA in the third month was significantly lower than that in the B group (2 16 vs 2 47, P = 0 0 48). Conclusion The reduction of ST segment of ST segment after PTCA in acute myocardial infarction was more than 50% in AMI, and the recovery of left ventricular systolic function and ventricular wall motion in acute and congestive AMI were better than that of S