急性ST段抬高心肌梗死直接经皮冠状动脉介入术冠状动脉无复流患者的左室功能Analysis of left ventricular function in ST segment elevationacute myocardial infarction for angiographic no-reflow phenomenon after primary percutaneous coronary intervention
杨新春,郭军,王乐丰,程祖亨,葛永贵,王红石,佟子川,邹阳春,王立忠,李惟铭,徐立,连勇
摘要(Abstract)：
目的 研究急诊经皮冠状动脉介入 (PCI)治疗冠状动脉 (冠脉 )无复流病人的左室功能。方法 自 1999年 1月至 2 0 0 2年 10月 ,回顾性分析北京朝阳医院心脏中心 4 97例急性ST段抬高心肌梗死 (STEMI)直接PCI患者的临床和影像资料。急诊PCI支架置入即刻 ,在无影响血流的血栓、栓塞、夹层、痉挛情况下 ,冠脉造影前向血流≤TIMI 2级为无复流 ,TIMI 3级为正常血流。冠脉无复流患者 5 8例 ,利用Excel随机函数表 ,由其余 4 39例急诊PCI冠脉前向血流恢复正常的患者中随机抽取6 0例 ,为正常血流组。结果 无复流和正常血流患者的肌酸肌酶峰值、Killip心功能分级、Q波计数、WMS有显著性差异 (P <0 0 5 )。正常血流患者术后 2周WMS改善 ,LVEF、CI、SVI增加 (P <0 0 5 )。正常血流合并心功能不全的患者术后 2周LVEF、CI、SVI增加 (P <0 0 5 ) ,LVEDV、LVESV(P <0 0 1)减少 ;而无复流合并心功能不全的患者LVEDV、LVESV增加 (P <0 0 1)。结论 无复流患者的心肌损害严重 ,梗死或濒临坏死的心肌范围广泛 ;室壁运动恢复较慢和局部心肌功能不良 ;左室舒缩功能降低
关键词(KeyWords)： 急性心肌梗死;经皮冠状动脉介入术;无复流;左室功能
基金项目(Foundation):
作者(Author): 杨新春,郭军,王乐丰,程祖亨,葛永贵,王红石,佟子川,邹阳春,王立忠,李惟铭,徐立,连勇
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