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目的探讨经皮冠状动脉介入(PCI)治疗对冠心病合并左心功能不全患者心功能的影响。方法选择62例行PCI的冠心病合并左心功能不全患者(PCI组),并选择同期基线资料相似的60例单纯应用药物治疗的冠心病合并左心功能不全患者作对照组。分别于PCI术前(或药物治疗前)及术后(或药物治疗后)6个月进行心脏彩色多普勒检测,比较2组心脏左室舒张末内径(LVDd)、左室收缩末内径(LVDs)、左室射血分数(LVEF)及左室短轴缩短率(FS)的变化,并依据临床表现比较2组NUHA心功能分级的改变。结果2组患者治疗6个月后,彩色多普勒检测各项左心功能指标均较治疗前明显改善(P均<0.05),且PCI组治疗后与对照组比较,其LVDd〔(45.26±12.85)vs(47.71±13.09)mm〕、LVDs〔(29.75±0.91)vs(31.06±0.61)mm〕、LVEF〔(50.56±5.91)%vs(47.62±8.52)%〕和FS〔(28.15±2.98)%vs(23.98±3.05)%〕四项指标均优于对照组(P均<0.05)。PCI组患者心功能(NYHA)改善情况优于对照组。结论PCI治疗可明显改善冠心病合并左心功能不全患者的心功能。
Objective To investigate the effect of percutaneous coronary intervention (PCI) on cardiac function in patients with coronary heart disease complicated with left ventricular dysfunction. Methods Sixty-two PCI patients with coronary heart disease complicated with left ventricular dysfunction (PCI group) undergoing PCI were selected and 60 patients with coronary heart disease complicated with left ventricular dysfunction who were treated with drugs with similar baseline data at the same period were selected as the control group. Color Doppler echocardiography was performed before PCI (before drug treatment) and after operation (or after drug treatment) for 6 months. The left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter LVDs, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (FS). The changes of two groups of NUHA scores were compared according to clinical manifestations. Results After six months treatment, the indexes of left ventricular function detected by color Doppler were significantly improved in both groups (all P <0.05). Compared with the control group, the LVDd 〔(45.26 ± LVDF 〔(29.75 ± 0.91) vs (31.06 ± 0.61) mm〕, LVEF 〔(50.56 ± 5.91)% vs (47.62 ± 8.52〕%〕 and FS 〔(28.15 ± 2.98)〕 vs (47.71 ± 13.09) mm〕 )% vs (23.98 ± 3.05)%] were better than the control group (all P <0.05). Cardiac function (NYHA) improvement in PCI group was better than that in control group. Conclusion PCI can significantly improve cardiac function in patients with coronary heart disease complicated with left ventricular dysfunction.