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目的:研究经皮冠状动脉介入治疗(PCI)对急性心肌梗死(AMI)患者室壁瘤形成的阻抑效应及心功能改善作用。方法:发病12h以内急性前壁心肌梗死伴室壁瘤形成患者随机分为直接PCI(A组36例),溶栓治疗(B组:31例),常规药物治疗(C组31例);各组患者均在治疗后1周、24周分别行超声心动图和平衡法核素心室造影评价左室质量指数(LVMI)和局部室壁运动积分(RWMI)、心室收缩同步性(VSS)和心功能(HF)等参数的改善状况。结果:治疗后1周和24周时,A组RWMI、VSS和HF均优于B组和C组,均P<0.05。A组和B组24周时上述各参数均优于1周。C组VSS参数中相角程在24周时较1周有所改善,余各项结果比较差异无统计学意义。结论:PCI治疗和溶栓对AMI患者室壁瘤有阻抑作用且改善心功能,而直接PCI优于溶栓治疗。
Objective: To investigate the inhibitory effect of percutaneous coronary intervention (PCI) on the formation of aneurysm and the improvement of cardiac function in patients with acute myocardial infarction (AMI). Methods: The patients with acute anterior myocardial infarction with aneurysm within 12 hours after onset were randomly divided into direct PCI (group A, 36 cases), thrombolytic therapy (group B: 31 cases) and routine drug treatment (group C, 31 cases) The patients were evaluated for left ventricular mass index (LVMI) and regional wall motion score (RWMI), ventricular systolic synchrony (VSS), and heart rate by echocardiography and balanced radionuclide ventriculography 1 week and 24 weeks after treatment, Function (HF) and other parameters to improve the situation. Results: RWMI, VSS and HF in group A were better than those in group B and group C at 1 week and 24 weeks after treatment, both P <0.05. The above parameters were better than 1 week in groups A and B at 24 weeks. The phase angle of VSS parameters in group C was improved at 24 weeks compared with that at week 1, and there was no significant difference among the results. Conclusion: PCI and thrombolytic therapy can inhibit the ventricular aneurysm in patients with AMI and improve cardiac function, whereas direct PCI is superior to thrombolytic therapy.