急性心肌梗死患者侧支血流分数与左室重塑关系的临床研究Relationship between pressure-derived fractional collateral flow and left ventricular remodeling in patients with acute myocardial infarction
欧知宏,方唯一,周旭晨,王珂,郑晓群,朱皓,蔡志雄,刘欣
摘要(Abstract)：
目的 应用压力导丝 ,通过冠状动脉内压力测定 ,评价急性心肌梗死 (AMI)患者侧支血流分数 (QC QN)与左室重塑的关系。方法 2 1例AMI患者 ,于经皮腔内冠状动脉成形术 (PTCA)时 ,对梗死相关动脉远端侧支血流行Rentrop分级并记录梗死相关动脉病变远端嵌楔压 (Pw)及主动脉压(Pa) ,据QC QN 值将 2 1例患者分为A组 (QC QN ≥ 0 .2 5 ) ,B组 (QC QN <0 .2 5 )。所有患者于AMI后 3d和 1个月行二维超声心动图检查 ,并进行统计学分析。结果 AMI后 3dA、B两组间EF分别为 (5 1 7± 7 1) %和 (45 6± 5 8) %(P <0 0 5 ) ;ESVI分别为 (2 5 0± 5 4 )ml m2 和 (30 5± 6 2 )ml m2 (P <0 0 5 ) ;EDVI分别为 (5 1 9± 9 8)ml m2 和 (5 5 4± 7 5 )ml m2 (P >0 0 5 )。AMI后 1个月 ,两组间EF分别为 (5 3 7± 7 1) %和 (43 9± 8 1) %(P <0 0 1) ;ESVI分别为 (2 7 1± 5 8)ml m2 和 (38 7± 11 5 )ml m2(P <0 0 1) ;EDVI分别为 (5 8 3± 7 5 )ml m2 和 (6 7 8± 13 0 )ml m2 (P <0 0 5 )。AMI后 1个月较 3d ,A组患者EF有明显改善 (P <0 0 5 ) ,B组EF变化不明显 (P >0 0 5 ) ;A、B两组患者ESVI和EDVI均有显著增大。结论 造影Rentrop分级对侧支循环的评价存在局限性 ;AM
关键词(KeyWords)： 急性心肌梗死;侧支血流分数;左室重塑
基金项目(Foundation):
作者(Author): 欧知宏,方唯一,周旭晨,王珂,郑晓群,朱皓,蔡志雄,刘欣
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