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目的:应用3T心脏磁共振成像探讨心肌梗死择期PCI治疗前后心肌相对梗死量、左室心功能、梗死远端节段、梗死邻近节段、梗死节段的局部室壁增厚率的变化及其相关性。方法:收集本院2014年8月至2016年3月22例急性心肌梗死的患者,在术前、术后1周内、术后6个月行磁共振检查。观察并比较三组病例心肌相对梗死量、左室心功能、梗死远端节段、梗死邻近节段和梗死节段的局部室壁增厚率的差异。结果:心肌相对梗死量的比较,术前术后1周内、术后6个月分别为(13.1±7.6)%、(9.4±6.6)%,(8.9±6.4)%,重复检验P<0.05,差异有统计学意义。左室心功能的比较,左室心功能指标随着时间的延长渐进增强。左室射血分数分别为(43.9±10.9)%,(46.7±10.8)%,(52.3±12.5)%。左室舒张末期容积(LVEDV)分别为(161.4±54.0)m L、(168.6±53.0)m L、(168.5±52.6)m L。左室收缩末期容积(LVSDV)分别为(91.62±43.5)m L、(91.3±43.7)m L、(82.5±43.4)m L,差异有统计学意义。室壁增厚率的变化,远端节段、近端节段及梗死透壁程度为1%~25%、26%~50%、51%~75%的心肌节段在术后1个月及半年室壁增厚率增加。梗死透壁程度在75%~100%的室壁增厚率在各时间点均未见明显改变。术前磁共振检查所见心肌梗死区域透壁程度越大,室壁增厚率越低,P<0.05。结论:择期PCI治疗可能缩小梗死心肌范围,改善总体心功能及局部心功能。3T心脏磁共振能够准确评价冠心病PCI疗效。
Objective: To investigate the changes of myocardial infarction volume, left ventricular cardiac function, distal infarction segments, adjacent infarction segments and infarct segments in patients with myocardial infarction undergoing elective PCI using 3T cardiac magnetic resonance imaging Correlation. Methods: Twenty-two patients with acute myocardial infarction from August 2014 to March 2016 in our hospital were enrolled in the study. MRI was performed preoperatively and within 1 week after operation and 6 months after operation. The differences in myocardial infarction volume, left ventricular cardiac function, distal infarction segments, adjacent infarction segments and infarct segments in three groups were observed and compared. Results: The myocardial infarction volume was (13.1 ± 7.6)%, (9.4 ± 6.6)% and (8.9 ± 6.4)% respectively within 1 week and 6 months after operation, P <0.05 ,The difference was statistically significant. Left ventricular cardiac function, left ventricular cardiac function gradually increased over time. Left ventricular ejection fraction were (43.9 ± 10.9)%, (46.7 ± 10.8)% and (52.3 ± 12.5)%, respectively. Left ventricular end-diastolic volume (LVEDV) were (161.4 ± 54.0) m L, (168.6 ± 53.0) m L and (168.5 ± 52.6) m L, respectively. The left ventricular end-systolic volume (LVSDV) were (91.62 ± 43.5) m L, (91.3 ± 43.7) m L and (82.5 ± 43.4) m L, respectively, with statistical significance. The changes of wall thickening rate, the distal segment, the proximal segment and the degree of transmural infarction were 1% ~ 25%, 26% ~ 50%, 51% ~ 75% of myocardial segments in 1 month after surgery And half a year wall thickening rate increased. Infarct wall thickness in the 75% to 100% of the wall thickening rate at any time point no significant change. Preoperative magnetic resonance imaging showed that the greater the extent of transmural myocardial infarction area, the lower the wall thickening rate, P <0.05. Conclusion: Elective PCI may reduce infarct size, improve overall cardiac function and local cardiac function. 3T cardiac magnetic resonance can accurately evaluate the efficacy of PCI in patients with coronary heart disease.