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目的:通过心脏超声应变显像检测与运动耐量调查,探讨经皮冠状动脉介入治疗术(PCI)开通前降支慢性完全闭塞(chronic total occlusion,CTO)病变前后患者心功能的变化。方法:选取冠状动脉前降支CTO病变患者75例,其中经PCI开通前降支CTO病变患者44例(开通组),试行PCI而未能开通者31例(对照组),测定并记录术前及术后3个月心脏多普勒超声及超声应变显像,并以体力活动调查问卷调查患者术前及术后3个月运动耐量变化。结果:2组患者术前及术后3个月传统心脏多普勒显像无显著改变,但术后3个月开通组多节段超声应变值较术前显著升高(P<0.01),与对照组相比差异有统计学意义(P<0.05),而开通组术后3个月运动耐量也较术前平均每天提高1.3个任务代谢当量(metabolic equivalent of task,MET),而对照组只较术前平均每天提高0.5 MET,2组间差异有统计学意义(P<0.05)。结论:开通冠脉CTO病变可以显著改善冠心病患者心功能及运动耐量。
Objective: To investigate the changes of cardiac function in patients with percutaneous coronary intervention (PCI) before and after chronic total occlusion (CTO). Methods: A total of 75 patients with CTO lesions of the anterior descending coronary artery were enrolled in this study. Totally, 44 patients with CTO lesion undergoing PCI (open group) were enrolled in this study. Totally 31 patients (control group) And Doppler echocardiography and ultrasonic imaging were performed at 3 months after operation. The changes of exercise tolerance in preoperative and postoperative 3 months were investigated by physical activity questionnaire. Results: There was no significant change in conventional heart Doppler imaging before and 3 months after operation in the two groups, but the multi-segment ultrasound in open group was significantly increased 3 months after operation (P <0.01) Compared with the control group, the difference was statistically significant (P <0.05), but the exercise tolerance at 3 months postoperatively in the open group was also increased by 1.3 metabolic equivalents of task (MET) Only 0.5 MET increased daily compared with the preoperative average. The difference between the two groups was statistically significant (P <0.05). Conclusion: Coronary CTO lesions can significantly improve cardiac function and exercise tolerance in patients with coronary heart disease.