冠脉介入治疗急性心肌梗死伴室壁瘤28例疗效观察

摘要

目的 观察冠脉介入(CPI)治疗急性心肌梗死(AMI)伴室壁瘤(LVA)患者的临床疗效.方法 对28例AMI伴LVA患者择期行PCI治疗.术前和术后观察患者是否有室性心律失常出现、心绞痛发生情况和心功能进展情况,通过心脏彩色多普勒超声检查观察患者左心室是否有血栓形成以及左心室质量指数(LVMI)、局部室壁运动积分(RWMI)、左心室射血分数(LVEF)等参数改善情况.结果 术后患者无左心室血栓形成,无严重室性心律失常、心绞痛和再次心肌梗死发生.术后6个月以后与术前比较,患者LVMI、RWMI、LVEF和心功能改善差异有显著性(P＜0.05).结论 对于年龄较大,急性前壁心肌梗死伴有中等程度及以下大小室壁瘤,前降支单支病变,特别是伴有侧枝循环的患者适合PCI治疗,能够改善患者生活质量和预后.%Objective The study was to observe the clinical effect of patients with ventricular aneurysm following acute myocardial infarction by percutaneous coronary intervention. Methods 28 patients with AM] accompanied LVA underwent elective PCI were enrolled in this study. The incidences of ventricular arrhythmia, angina pectoris attacks, heart function before and after elective PCI were assigned. Echocardiagraphy were performed to evaluate the left ventricular mass index, region wall movement index, left ventricular ejection fraction, embolism before and after elective PCI. Results There were no arrhythmogenesis, embolism, angina pectoris attacks, second heart attack after acute myocardial infarction. LVMI and RWMI were all decreased and cardiac function were inproved at 6 months after elective PCI. Conclusion Patients with anterior AMI accompanied a moderate and low size of the aneurysm, LAD single vessel coronary disease, coronary collateral circulation are suitable for PCI and PCI can effectively improve life quality and prognosis.