直接与延迟经皮冠状动脉介入术对急性心肌梗死患者血流动力学、左心室重构的影响比较

摘要

目的 比较直接与延迟经皮冠状动脉介入术(PCI)对急性心肌梗死患者血流动力学、左心室重构的影响.方法 选择2016年1月—2017年6月武汉市第五医院收治的急性心肌梗死患者142例,根据PCI时机分为对照组67例和观察组75例.在常规治疗基础上,对照组患者行延迟PCI,观察组患者行直接PCI.比较两组患者发病后1周、6个月血流动力学指标、左心室重构指标.结果 发病后1周两组患者平均左房室瓣压差(mMPG)、肺动脉平均压(mPAP)比较,差异无统计学意义(P>0.05);发病后6个月观察组患者mMPG、mPAP低于对照组(P<0.05).发病后1周两组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心房内径(LAD)比较,差异无统计学意义(P>0.05);发病后6个月观察组患者LVEDD、LVESD、LAD短于对照组(P<0.05).结论 与延迟PCI相比,直接PCI能更有效地改善急性心肌梗死患者血流动力学,抑制左心室重构.%Objective To compare the impact on haemodynamics and left ventricular remodeling in patients with acute myocardial infarction between direct and delayed PCI.Methods A total of 142 patients with acute myocardial infarction were selected in the Fifth Hospital of Wuhan from January 2016 to June 2017,and they divided into control group(n=67) and observation group(n=75)according to the opportunity for PCI. Based on conventional treatment,patients in control group received delayed PCI,while patients in observation group received direct PCI. Index of haemodynamics and left ventricular remodeling were compared between the two groups 1 week and 6 months after attack.Results No statistically significant differences of mMPG or mPAP was found between the two groups 1 week after attack(P>0.05),while mMPG and mPAP in observation group were statistically significantly lower than those in control group 6 months after attack(P<0.05). No statistically significant differences of LVEDD,LVESD or LAD was found between the two groups 1 week after attack(P>0.05);while LVEDD,LVESD and LAD in observation group were statistically significantly shorter than those in control group 6 months after attack(P<0.05).Conclusion Compared with delayed PCI,direct PCI can more effectively improve the haemodynamics and inhibit the left ventricular remodeling in patients with acute myocardial infarction.