超声心动图和脑钠肽对急性心肌梗死择期冠状动脉介入治疗后左心室重构的评价 作者:丁少娟,聂文丽,甄晓敏,李文 【摘要】目的评价择期行冠状动脉支架植入术对急性心肌梗死左心室重构的影响。方法首次急性心肌梗死(AMI)住院患者22例为A组,择期行冠状动脉支架植入术治疗;同期首次AMI住院患者16例常规治疗,为B组。所有患者在入院时及介入治疗后72 h、3个月免疫荧光测定法测定脑钠肽(BNP),超声心动图检查左心室室壁运动积分指数(WMSI)、左心室舒张末期容积指数(LVEDVI)、左心室收缩末期容积指数(LVESVI)及左心室射血分数(LVEF),对治疗前后指标变化进行分析。结果入院时A、B两组BNP、WMSI、LVEF、LVEDVI、LVESVI 差异无统计学意义(P>)。介入术后72 h、3个月A组BNP水平低于同期B组(P<),且较入院时降低(P<);A组超声检测指标3个月后明显改善,较同期B组差异有统计学意义(P<)。结论超声心动图和BNP有助于评价AMI择期冠状动脉支架植入术后左心室重构,对判断预后有一定价值。 【关键词】急性心肌梗死;超声心动图;脑钠肽;冠状动脉介入治疗;左心室重构;评价 Abstract:Objective To evaluate the effects of selective percutaneous coronary intervention (PCI) on left ventricular remodeling in patients with acute myocardial infarction (AMI).Methods 22 patients with their first AMI were selected as group A and underwent selective PCI, and meanwhile 16 patients with first AMI in group B, were given routine treatment instead of PCI. All the patients underwent the following examinations at admission as well as 72 hours and three months following intervention: immunofluorescence assay for brain natriuretic peptide(BNP) determination, Doppler echocardiographic examination for the alterations of left ventricular wall motion score index (WMSI), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI) and left ventricular ejection fraction (LVEF). All these data were collected and