摘要
目的 :评价再血管化治疗对急性心肌梗死 (AMI)患者神经内分泌激素水平及心功能的影响。方法 :将 68例AMI患者按是否行再血管化治疗分为急诊冠状动脉介入治疗 (PCI)组 2 0例 ,延迟PCI组 2 6例 ,未行再血管化治疗的对照组 2 2例 ,3组患者基础临床特征无统计学差异。于心肌梗死急性期和心肌梗死术后 6个月分别采血检测血浆肾素活性 (PRA)、血管紧张素Ⅱ (AngⅡ )浓度、血浆醛固酮 (Ald)浓度、血浆去甲肾上腺素 (NE)和肾上腺素(E)浓度 ,并测定左心室室壁运动指数 (WMI)、左心室射血分数 (LVEF)、左心室舒张末期容积指数 (LVEDVI)和收缩末期容积指数 (LVESVI)变化。结果 :①无论急诊PCI组还是延迟PCI组 ,血浆肾素活性、血管紧张素Ⅱ、血浆醛固酮等激素水平术后 6个月均有明显下降 ,而未行再血管化手术治疗的对照组激素水平无显著变化。②在急诊PCI组和延迟PCI组术后 6个月与急性期比较左心室射血分数增加 ,左心室室壁运动指数减小 ;延迟PCI组术后 6个月时的左心室收缩末期容积指数较急性期减小 ;急诊PCI组和延迟PCI组 6个月的左心室收缩末期容积指数和室壁运动指数明显小于对照组 ,均有显著性差异 (P <0 0 5 )。结论 :无论急诊PCI还是延迟PCI均可以降低心肌梗死后神经内分泌激素的过度激活 。
Objective: To investigate the effects of revascularization on neurohormone and h eart function in patients with acute myocardial infarction(AMI). Methods: Sixty-eight patients with AMI were divided into 3 groups according to percutaneous coronary intervention(PCI): emergency PCI group (n=20), delayed PCI group (n=26) and control group (n=22). Before and 6 months after tr eatment plasma rennin activity (PRA), plasma concentration of angiotensinⅡ(Ang Ⅱ), aldosterone (Ald), norepinephrine (NE) and epinephran (E) were measured. Me anwhile left ventricular wall motion score index(WMI), left ventricular end dias tolic volume (LVEDV) and systolic volume (LVESV), and left ventricular ejection fraction (LVEF) were detected. Results: The plasma concentration of PRA,AngⅡ and NE in emergency PCI group an d delayed PCI group were significantly reduced. In the 6th month, LVEF and WMI h ad significant improvement in both PCI therapy groups and LVESVI decreased in de layed PCI group compared with those in acute phase. LVESVI and WMI of both PCI groups were significantly lower than those of control group after treatment. Conclusion: Revascularization can decrease the activation of neurohormone in pat ients with AMI, prevent cardiac remodeling and improve heart function.
出处
《中国循环杂志》
CSCD
北大核心
2004年第1期31-33,共3页
Chinese Circulation Journal
关键词
再血管化治疗
急性心肌梗死
血浆激素
心功能
Myocardial infarction
Angioplasty, translumina l, percutaneous coronary
Hormones
Heart function
