【摘要】 目的　本研究评价延迟的经皮冠状动脉腔内成形术 (PTCA)所产生的梗死区再灌注血流对急性心肌梗死 (AMI)患者左心室功能恢复的影响。方法　 33例初次Q波型AMI患者 ,于发病 2～3周内分别进行PTCA治疗。全部病例梗塞相关血管均为完全或次全闭塞病变。经过左心室造影应用面积长轴法计算每例患者的左室射血分数 (LVEF) ,梗塞区室壁运动百分率 ,左心室舒张末容积指数 (EDVI)及Cortina室壁运动不良积分。PTCA 6个月后所有患者重复进行左心室造影及重复以上指标的测量。结果　在PTCA 6个月后 ,本组病例表现出左室局部及整体收缩功能明显改善 [LVEF(5 5 2± 10 1) %vs (4 9 2± 9 9) % ,P <0 0 1]。梗塞区收缩百分率 [(12 8± 5 2 ) %vs (11 5± 6 0 ) % ,P <0 0 5 ]。Cortina室壁运动不良积分下降 [(7 6± 3 2 )vs (9 2± 2 8) ,P <0 0 1]。而EDVI则无明显变化 ,说明左心室的扩张受到了限制。结论　提示Q波型急性心肌梗死接受延迟的PTCA再血管化治疗有益于患者左心功能的恢复。更多还原

【Abstract】 The Purpose of this study was to assess the effect of late revascularization by primary percutaneous transluminal coronary angioplasty (PTCA) on left ventricular function of myocardial infarction Methods In 33 Patients with initial Q-wave myocardial infarction PTCA were performed within 2～3 weeks after myocardial infarction The infarct-related artery is total or subtotal occlusion in every patient Left ventricular ejection fraction (LVEF), percent regional wall motion of infarcted wall, cortina dysfunction score and end-diastolic volume index (EDVI) were calculated by left ventriculography A second ventricular angiogram was performed 6 months later in all patients and the measurement was repeated Results 6 months after PTCA, the patients showd a significant improvement of LVEF [(55 2±10 1)% vs (49 2±9 9)%, P <0 01] and percent regional wall motion of infarcted wall [(12 8±5 2)% vs (11 5±6 0)%, P <0 05] The cortina dysfunction score was reduced significantly [(7 6±3 2) vs (9 2±2 8), P <0 01] The EDVI remains unchanged, the ventricular dilation probably had been prevented Conclusion In initial Q-wave myocardial infarction, we conclude that even with late reperfusion, PTCA had beneficial effects on left ventricular function更多还原