心肌存活及灌注對急性心肌梗死冠狀動脈介入治療術后患者心功能的影響_《華西醫學》

作者：

依力米努爾阿合買提江 ,  彭輝

新疆維吾爾自治區人民醫院心內科（烏魯木齊，830054）;

關鍵詞：

存活心肌急性心肌梗死心功能

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目的　探討急性心肌梗死冠狀動脈介入治療（PCI）術后患者梗死區心肌存活性對左室重構及功能的影響。方法　2006年2月－2010年12月208例急性心肌梗死急診PCI術后的患者接受靜息狀態下18氟-脫氧葡萄正電子斷層顯像進行心肌代謝顯像檢查，根據基線梗死區心肌有無存活分為兩組，同時進行超聲心動圖檢查，評價左室壁運動、左室射血分數，左室舒張末內徑、左房內徑及舒張期二尖瓣血流速度峰值的比值。血運重建術后12個月隨訪超聲心動圖，觀察梗死區心肌存活狀態對于左室重構以及心功能的影響。結果　PCI術后12個月，有存活心肌組左室射血分數（46.7 ± 6.98）%高于無存活心肌組（45.1 ± 7.12）%，兩組差異有統計學意義（P＜0.01），有存活心肌組左室舒張末期內徑（53.17 ± 3.89） mm小于無存活心肌組（55.46 ± 4.75） mm，兩組差異有統計學意義（P＜0.05）。左房內徑及舒張期二尖瓣血流速度峰值的比值兩組隨訪時均無明顯變化。結論　急性心肌梗死行PCI治療后的患者，在有存活心肌的情況下，心功能改善明顯；而梗死區無心肌存活的患者，12個月后，心功能減低，左室重構更加明顯。

引用本文： 依力米努爾阿合買提江,彭輝. 心肌存活及灌注對急性心肌梗死冠狀動脈介入治療術后患者心功能的影響. 華西醫學, 2012, 27(8): 1126-1128. doi: 復制

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1. 　Machac J. Cardiac positron emission tomography imaging[J]. Semin Nucl Med, 2005, 35(1): 17-36.
2. 　Allman KC, Shaw LJ, Hachamovitch R, et al. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis[J]. J Am Coll Cardiol, 2002, 39(7): 1151-1158.
3. 　Kudo T. Metabolic imaging using PET[J]. Eur J Nucl Med Mol Imaging, 2007, 34(Suppl 1): S49-S61.
4. 　Gimelli A, Rossi G, Landi P, et al. Stress/rest myocardial perfusion abnormalities by gated SPECT: still the best predictor of cardiac events in stable ischemic heart disease[J]. J Nucl Med, 2009, 50(4): 546-553.
5. 　Stirrup J, Maenhout A, Wechalekar K, et al. Radionuclide imaging in ischaemic heart failure[J]. Br Med Bull, 2009, 92: 43-59.
6. 　Beanlands R, Nichol G, Huszti E, et al. F-18-fluorodeoxyglucose positron emission tomography imaging-assisted management of patients with severe left ventricular dysfunction and suspected coronary disease: a randomized, controlled trial (PARR-2)[J]. J Am Coll Cardiol, 2007, 50(20): 2002-2012.
7. 　Bax RH, van JJ, Veldhuisen DJ, et al. Prediction of functional recovery after revascularization in patients with chronic ischaemic left ventricular dysfunction:head-to-head comparison between 99mTcsestamibi/18F-FDG DISA SPECT and 13N-ammonia/18F-FDG PET[J]. Eur J Nucl Med Mol Imaging, 2006, 33(6): 716-723.
8. 　Zhang X, Liu XJ, Wu Q, et al. Clinical outcome of patients with previous myocardial infarction and left ventricular dysfunction assessed with myocardial (99m)Tc-MIBI SPECT and (18)F-FDG PET[J]. J Nucl Med, 2001, 42(8): 1166-1173.
9. 　Toyama T, Hoshizaki H, Seki R, et al. Evaluation of myocardial viability following acute myocardial infarction using 201Tl SPECT after thallium-glucose-insulin infusion--comparison with 18F-FDG positron emission tomography[J]. Ann Nucl Med, 2004, 18(6): 463-468.
10. 　Demirkol MO. Myocardial viability testing in patients with severe left ventricular dysfunction by SPECT and PET[J]. Anadolu Kardiyol Derg, 2008, 8(Suppl 2): 60-70.
11. 　Desideri A, Cortigiani L, Christen AI, et al. The extent of perfusion-F18-fluorodeoxyglucose positron emission tomography mismatch determines mortality in medically treated patients with chronic ischemic left ventricular dysfunction[J]. J Am Coll Cardiol, 2005, 46(7): 1264-1269.
12. 　Chareonthaitawee P, Gersh BJ, Araoz PA, et al. Revascularization in severe left ventricular dysfunction: the role of viability testing [J]. J Am Coll Cardiol, 2005, 46(4): 567-574.

《華西醫學》

心肌存活及灌注對急性心肌梗死冠狀動脈介入治療術后患者心功能的影響

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《華西醫學》

心肌存活及灌注對急性心肌梗死冠狀動脈介入治療術后患者心功能的影響

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料