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目的应用定量组织速度显像评价早期的延迟PCI再灌注治疗(STEMI发病12~24 h内)对急性心肌梗死收缩和舒张功能的影响。方法本研究共入选35例在发病12h-24h仍有进行性缺血性胸痛的急性ST段抬高性的心肌梗死患者,于PCI术前及术后3个月分别测定二尖瓣环收缩期、舒张早期和舒张晚期运动速度峰值Sa、Ea和Aa,并计算舒张早期运动速度峰值与舒张晚期运动速度峰值的比值Ea/Aa。结果 1二尖瓣环收缩期运动速度峰值:术后3个月比术前升高,差异有统计学意义(P<0.05);2二尖瓣环舒张早期运动速度峰值:术后3个月、与术前对比有明显升高,差异有统计学意义(P<0.05)。3二尖瓣环舒张早期运动速度峰值/舒张晚期运动速度峰值比值(Ea/Aa):术后3个月与术前对比有明显升高,差异有统计学意义(P<0.05)。结论早期的延迟PCI再灌注治疗可以改善急性心肌梗死患者的左心室收缩和舒张功能;定量组织速度显像可以评价急性心肌梗死患者急诊PCI术后左心室收缩和舒张功能变化。
Objective To evaluate the effect of early delayed PCI reperfusion (within 12 to 24 hours after onset of STEMI) on the contractile and diastolic function of acute myocardial infarction (AMI) by quantitative tissue velocity imaging. Methods A total of 35 patients with acute ST-segment elevation myocardial infarction who still had progressive ischemic chest pain at 12h-24h after onset were enrolled in this study. Mitral annulus contractions were measured before and 3 months after PCI , Peak early diastolic and diastolic velocity Sa, Ea and Aa, and the ratio of peak early diastolic velocity to peak diastolic velocity Ea / Aa was calculated. Results 1 Mitral annulus systolic velocity peak: 3 months after surgery than before surgery, the difference was statistically significant (P <0.05); 2 mitral annular early diastolic velocity peak: 3 months after surgery , Which was significantly higher than that before operation, the difference was statistically significant (P <0.05). Ea / Aa: The peak value of diastolic early diastolic velocity / late diastolic velocity of mitral annulus was significantly increased at 3 months after operation compared with that before operation, the difference was statistically significant (P <0.05). Conclusion Early delayed PCI reperfusion can improve left ventricular systolic and diastolic function in patients with acute myocardial infarction. Quantitative tissue velocity imaging can be used to evaluate left ventricular systolic and diastolic function after emergency PCI in patients with acute myocardial infarction.