吕昀,曾亚莉,郭晔炳,柳景华,赵东晖,黄方炯,王盛宇,谢进生

• 1:北京首都医科大学附属北京安贞医院
• 2:北京市心肺血管疾病研究所
• 3:煤炭总医院心内科

摘要(Abstract)：

目的探讨不同血运重建方法对陈旧前壁心肌梗死合并左心室室壁瘤患者的左心室重塑指标、心功能以及远期预后的影响。方法共入选Euro Score评分中低危的患者223例,分为经皮冠状动脉介入治疗(PCI)组129例和冠状动脉旁路移植术(CABG)组94例。患者分别于血运重建术前、术后6个月行超声心动图检查,随访36个月记录主要终点事件(全因死亡、脑卒中、心肌梗死)及主要不良心脏事件(MACE)发生情况。结果接受血运重建术前,PCI组与CABG组患者左心室舒张末期内径(LVEDd)[(58.12±10.01)mm比(61.75±5.85)mm]、左心室射血分数(LVEF)[(43.57±9.41)%比(42.98±10.98)%]、左心室质量指数(LVMI)[(122.47±15.36)g/m2比(126.22±16.58)g/m2]比较,差异均无统计学意义(均P>0.05)。PCI组术后6个月较术前LVEDd[(52.32±4.23)mm比(58.12±10.01)mm,P<0.05]、LVEF[(56.56±9.65)%比(43.57±9.41)%,P<0.05]和LVMI[(107.54±15.25)g/m2比(122.47±15.36)g/m2,P<0.05]显著改善。CABG组术后6个月较术前LVEDd[(53.65±3.72)mm比(61.75±5.85)mm,P<0.05]、LVEF[(57.70±10.65)%比(42.98±10.98)%,P<0.05]和LVMI[(109.43±14.35)g/m2比(126.22±16.58)g/m2,P<0.05]也显著改善。累积36个月随访发现,PCI组主要终点事件和MACE发生率高于CABG组,但差异无统计学意义(13.2%比12.8%,χ2=0.29,P>0.05;12.4%比6.4%,χ2=2.22,P>0.05)。结论不同血运重建方法均显示术后6个月LVEF升高、LVMI降低,但在心功能、左心室重塑、主要终点事件以及MACE改善方面,CABG术与PCI术间差异无统计学意义。

关键词(KeyWords)： 心肌梗死;室壁瘤;血运重建;重塑;预后

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 吕昀,曾亚莉,郭晔炳,柳景华,赵东晖,黄方炯,王盛宇,谢进生

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