论文部分内容阅读
目的对接受急诊、易化、延迟介入治疗(PCI)的急诊心肌梗死(AMI)患者心功能及心肌组织血液灌注进行评价。探讨AMI患者行PCI最佳时机和方法。方法69例AMI患者分急诊PCI(A)、易化PCI(B)、延迟PCI(C)三组。术后7d、30d行超声心动图及99 mTc-甲氧基异丁基异晴(MIBI)心肌灌注断层显像(SPECT)评价近期心功能及心肌组织灌注,观察1年期间心血管事件的发生情况。结果(1)三组患者扩张后即刻造影结果管腔残余狭窄率<10%,手术成功率100%。(2)超声心动图30d时A、B两组左心室收缩、舒张末容积指数(LVESVI、LVEDVI)、左心室射血分数(LVEF)均优于C组(。3)SPECT显像放射性缺损面积(MIA),A、B两组低于C组,A、B两组心肌组织血流灌注均优于C组。结论(1)直接PCI、易化PCI可显著提高AMI患者的近期心肌组织血流灌注,缩小心肌梗死面积,保护心功能;(2)延迟PCI宜早期进行。
Objective To evaluate the cardiac function and myocardial perfusion in patients with emergency myocardial infarction (AMI) receiving emergency treatment, facilitation and delayed interventional therapy (PCI). To investigate the best timing and method of PCI for AMI patients. Methods 69 patients with AMI were divided into three groups: emergency PCI (A), easy PCI (B) and delayed PCI (C). Echocardiography and 99mTc-MIBI myocardial perfusion imaging (SPECT) at postoperative 7d and 30d were used to evaluate the recent cardiac function and myocardial perfusion. The incidence of cardiovascular events during one year was observed. Results (1) Immediately after the expansion of the three groups, the residual luminal stenosis rate was less than 10% and the successful rate was 100%. (2) The left ventricular systolic and diastolic volume index (LVESVI, LVEDVI) and left ventricular ejection fraction (LVEF) in group A and B at 30 days after echocardiography were better than those in group C (.3) (MIA). A and B groups were lower than C group. A group and B group were better than C group in perfusion. Conclusions (1) Direct PCI and easy-to-use PCI can significantly improve the myocardial perfusion, shorten the area of myocardial infarction and protect cardiac function in patients with AMI. (2) Delayed PCI should be performed in the early stage.