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| 经皮冠状动脉介入术对急性心肌梗死患者合并二尖瓣反流的影响 |
| 徐勇,孙琪,智光,韩宝石,盖鲁粤,杨庭树,XUYong,SUNQi,ZHIGuang,HANBao-shi,GELu-yue,YANGTing-shu |
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| 摘要: |
| 目的:通过6个月以上随访观察,探讨经皮冠状动脉介入术(PCI)对急性心肌梗死(AMI)合并二尖瓣反流(MR)的影响.方法:213例AMI患者按治疗方法不同分为常规药物组(126例,服用常规药物)和PCI组(87例,PCI+常规药物),所有患者在住院期间及随访时行超声心动图检查,检测MR程度、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVEDs)、左室舒张末期容量(LVEDV)、左室收缩末期容量(LVESV)、左室射血分数(LVEF),将所得结果进行对比分析.结果:AMI患者住院期间MR的发生率为28.6％,下壁心梗MR发生率明显高于其他部位(34.5％vs 22.3％,P＜0.01).平均随访8.8个月后MR的总发生率为35.4％,PCI组MR发生率较住院期间无显著变化(26.4％vs 27.6％,P＞0.05),而常规药物组MR发生率较心梗急性期有明显增加(43.7％vs30.2％,P＜0.01),且明显高于PCI组(P＜0.01).PCI组LVEDd、LVEDV、LVESV低于常规药物组(P＜0.05),而LVEF高于常规药物组(P＜0.05).结论:急性下壁心肌梗死患者较其他部位心梗患者易出现MR;随着心肌梗死时间延长,MR发生率有增加趋势.PCI通过改善血流及左室重构,可降低或至少不增加MR的发生. |
| 关键词: 急性心肌梗死、二尖瓣反流、经皮冠状动脉介入术 |
| DOI：10.3724/SP.J.1008.2006.00638 |
| 投稿时间：2006-05-05修订日期：2006-05-30 |
| 基金项目: |
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| Effect of percutaneous coronary intervention on mitral regurgitation in patients with acute myocardial infarction: a 6 months follow-up |
| 徐勇,孙琪,智光,韩宝石,盖鲁粤,杨庭树,XU Yong,SUN Qi,ZHI Guang,HAN Bao-shi,GE Lu-yue,YANG Ting-shu |
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| Abstract: |
| Objective：To evaluate the effect of percutaneous coronary intervention（PCI） on mitral regurgitation （MR） in patients with acute myocardial infarction （AMI）. Methods, A total of 213 AMI patients were divided into PCI group（n = 87, PCI ＋ medication） and medication group（n= 126,medication） according to the treatments they received. Echocardiographic examination was conducted in patients during admission and 6 months follow-up. Color Doppler was used to determine the degree of MR. Echocardiogram indices included MR degree, left ventricular end-diastolic diameter （LVEDd）,left ventricular end-systolic diameter （LVEDs） ,left ventricular end-diastolic volume （LVEDV） ,left ventricular end-systolic volume（LVESV）, and left ventricular ejection fraction （LVEF）. Results： The overall incidence of MR was 28.6% in 213 patients during admission. The MR incidence in patients with acute inferior myocardial infarction was higher than that in patients with other parts of infarction （34.5 % vs 22.3 %, P〈0.01）. MR was found in 35.4 % patients during an average follow-up of 8.8 months. The MR incidence of PCI group was similar to that during admission（26.4% vs 27.6% ,P〈0.05）, while the incidence in medication group increased significantly than that during admission（43.7 % vs 30.2 %, P〈0.01）. Although the MR incidences were not significantly different between the 2 groups during admission, the incidence of medication group was significantly higher than that of PCI group during 8.8 months follow-up（P〈0.01）. LVEDd, LVEDV and LVESV in PCI group were smaller than those in medication group（P〈0.05） ,while LVEF in PCI group was higher than that in medication group（P〈0.05）. Conclusion： The MR incidence in patients with acute inferior myocardial infarction is higher than that in other patients. MR has an increasing trend as the time of myocardial infarction lasts. PCI can prevent MR through improving blood flow and left ventricular remodeling |
| Key words: acute myocardial infarction mitral regurgitation percutenous coronary intervention |
