[1]韩培天 魏晓岩 杜彬彬 张津宁 王文州 郭艳娇 张克成 李春彦 李文慧.心肌缺血时间对STEMI患者急诊PCI术后早期左室舒张功能的影响及相关因素分析[J].心血管病学进展,2020,(6):660.[doi:10.16806/j.cnki.issn.1004-3934.2020.06.024]
　HAN Pei-tian,WEI Xiaoyan,DU Binbin,et al.Effect of Myocardial Ischemia Duration on Early Left Ventricular Diastolic Function in STEMI Patients After Emergency PCI and Analysis of Related Factors[J].Advances in Cardiovascular Diseases,2020,(6):660.[doi:10.16806/j.cnki.issn.1004-3934.2020.06.024]
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心肌缺血时间对STEMI患者急诊PCI术后早期左室舒张功能的影响及相关因素分析()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年6期
页码:
660
栏目:
论著
出版日期:
2020-06-25

文章信息/Info

Title:
Effect of Myocardial Ischemia Duration on Early Left Ventricular Diastolic Function in STEMI Patients After Emergency PCI and Analysis of Related Factors
作者:
韩培天 魏晓岩 杜彬彬 张津宁 王文州 郭艳娇 张克成 李春彦 李文慧
 (河北北方学院附属第二医院心内科,河北 张家口 075100 )
Author(s):
HAN Pei-tian;  WEI Xiaoyan;  DU Binbin;  ZHANG Jinning;  WANG Wenzhou;  GUO Yanjiao;  ZHANG Kecheng;  LI ChunYan;  LI Wenhui
(Department of Cardiology,The Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,Hebei,China) (1821032 D) E-mail zyeflwh@163.com
关键词:
ST段抬高型心肌梗死; 超声心动图; 经皮冠状动脉介入治疗; 舒张功能
Keywords:
ST-segment elevation myocardial infarction;  Echocardiography;  Percutaneous coronary intervention;  Diastolic function
DOI:
10.16806/j.cnki.issn.1004-3934.2020.06.024
摘要:
目的 应用超声心动图评价急性ST段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉内介入术（PCI）后1周的舒张功能，探讨STEMI患者急诊PCI术后早期左室舒张功能的影响因素及对策。方法 对入选的213例STEMI患者根据心肌总缺血时间分为早期再灌注组（TTT＜6 h）和晚期再灌注组（TTT≥6 h），对比分析两组患者PCI术后1周超声心动图指标。结果 （1）两组患者在年龄、性别、高血压和糖尿病等基线资料方面无明显差异；（2）两组患者超声心动图E[（79.3±20.4）vs（68.0±18.9）]、e’[（7.13±2.24）vs（5.88±1.71）]、E/e’[（14.47±5.82）vs（10.96±3.66）]和LAVI[（41.02±13.11）vs（37.78±10.78）]，差异有统计学意义（P均＜0.05）；（3）单因素线性回归分析显示：对E/e’有明显影响的是高血压（OR 2.136 ，P=0.038）、LAD闭塞（OR 5.077 ，P=0.006）、BNP（OR 3.911 ，P=0.027）和总缺血时间（OR 25.383 ，P＜0.001）；而多因素回归分析显示：总缺血时间（OR 18.541，P＜0.001）和前降支闭塞（OR 3.347 ，P=0.031）仍是E/e’的主要影响因素。结论 影响STEMI患者急诊PCI术后1周心室舒张功能的主要因素是心肌总缺血时间和前降支病变，且先于收缩功能出现障碍之前。
Abstract:
Objective Echocardiography was used to evaluate the diastolic function in patients with acute ST-elevation myocardial infarction (STEMI) 1 week after emergency percutaneous coronary intervention(PCI) to explore the influencing factors and countermeasures of early left ventricular diastolic function. Methods According to the total myocardial ischemic time,213 STEMI patients were divided into the early reperfusion group (TTT＜6h) and the late reperfusion group (TTT≥6h). The echocardiographic indicators of 1 week post PCI were compared between two groups. Results (1) There were no significant differences between the two groups in terms of baseline data such as age,gender,hypertension and diabetes. (2) There were statistically significant differences in echocardiographic indicators E[(79.3±20.4)vs(68.0±18.9)],e’ [(7.13±2.24)vs(5.88±1.71)],E/e’ [(14.47±5.82)vs(10.96±3.66)],and LAVI[(41.02±13.11)vs(37.78±10.78)] between the two groups of patients (P＜0.05).(3) Univariate linear regression analysis showed that hypertension(OR 2.136， P=0.038),LAD occlusion(OR 5.077， P=0.006),BNP(OR 3.911 P=0.027),and total ischemic time(OR 25.383 ,P＜0.001) had a significant effect on E/e’ . Multivariate regression analysis showed that total ischemic time(OR 18.541 ,P＜0.001) and anterior descending occlusion (OR 3.347 ，P=0.031) were still the main influencing factors of E/e’. Conclusions The duration of total myocardial ischemia and anterior descending branch lesion prematurely precede ventricular systolic dysfunction , which are the main factors affecting ventricular diastolic function in patients with STEMI 1 week after emergency PCI.

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备注/Memo

备注/Memo:
基金项目：张家口市科学技术研究与发展指导计划项目（1821032 D）
更新日期/Last Update: 2020-09-22