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目的评价晚期选择性PCI对老年心肌梗死患者左室功能的作用。方法对45例老年首次心肌梗死患者,平均于发病后(3.9±2.2)周行冠状动脉造影,并进行前瞻性研究。按梗死相关冠状动脉是否进行PCI分为两组:PCI组:25例,为平均于(4.9±3.1)周行成功PCI患者;对照组:20例,为未行PCI患者。对PCI组患者,于术前平均(4.6±3.2)d及术后随访期平均(6.8±2.3)个月及对照组患者于相当于PCI组术前和随访期时间进行12导联心电图和心脏超声检查,以评价心电图QRS积分、左室容量、收缩及舒张功能的改变。结果PCI组术后随访期左室容量较术前减小、QRS积分减低,左室收缩功能明显改善,而左室舒张功能无明显变化。与对照组相比,PCI组随访期左室容量较小,而收缩及舒张功能明显好于对照组。结论对老年心肌梗死患者,晚期选择性PCI能阻止左室重构,改善患者的远期左室功能,对临床明显有益。
Objective To evaluate the effect of late selective PCI on left ventricular function in elderly patients with myocardial infarction. Methods Coronary angiography was performed in 45 elderly patients with first myocardial infarction on average after the onset of disease (3.9 ± 2.2) weeks and prospectively studied. PCI was divided into two groups based on whether or not coronary artery was infarcted: PCI group: 25 patients with a mean of (4.9 ± 3.1) weeks of successful PCI and control group of 20 patients with no PCI. The mean preoperative (4.6 ± 3.2) days and postoperative follow-up were (6.8 ± 2.3) months in the PCI group and 12-lead ECG and heart in the control group before and at the follow-up period corresponding to the PCI group Echocardiography was performed to assess changes in electrocardiographic QRS scores, left ventricular volume, systolic and diastolic function. Results After PCI, the left ventricular volume was decreased and the QRS score was decreased. The left ventricular systolic function was significantly improved, while the left ventricular diastolic function did not change significantly. Compared with the control group, the left ventricular volume was smaller in the PCI group and the systolic and diastolic function was significantly better than that in the control group. Conclusion In elderly patients with myocardial infarction, advanced selective PCI can prevent left ventricular remodeling and improve long-term left ventricular function in patients with significant clinical benefits.