本文選題：心肌梗死 + 梗死面積�。� 參考：《山東醫(yī)藥》2017年27期

【摘要】：目的觀察急性ST段抬高型心肌梗死(STEMI)患者介入治療(PCI)后6個(gè)月左心室整體縱向應(yīng)變(GLS)及心肌梗死面積(IS)的變化,并探討二者與PCI術(shù)后6~12個(gè)月主要不良心血管事件(MACE)發(fā)生情況的關(guān)系。方法選擇60例PCI術(shù)后STEMI患者(其中7例PCI術(shù)后6~12個(gè)月發(fā)生MACE)。PCI術(shù)后7 d、6個(gè)月分別采用二維超聲心動(dòng)圖斑點(diǎn)追蹤成像技術(shù)測算左心室GLS,采用延遲增強(qiáng)心磁共振技術(shù)測算左心室IS。結(jié)果本組患者PCI術(shù)后7 d、6個(gè)月左心室GLS分別為-14%±3%、-17%±3%,IS分別為23%±7%、19%±6%。本組患者PCI術(shù)后6個(gè)月左心室GLS、IS均低于術(shù)后7 d,P均0.05。相關(guān)性分析顯示,本組患者PCI術(shù)后左心室GLS和IS呈負(fù)相關(guān)(r=-0.756,P0.01)。本組患者PCI術(shù)后6個(gè)月左心室GLS較術(shù)后7 d降低2%~4%,中位數(shù)為3%。以PCI術(shù)后6個(gè)月左心室GLS較術(shù)后7 d降低幅度的中位數(shù)為界值將本組患者分為GLS明顯降低組(降低幅度≥中位數(shù))26例和GLS無明顯降低組(降低幅度中位數(shù))34例,其中分別有0、7例患者隨訪過程中發(fā)生MACE,兩組MACE發(fā)生率相比,P0.05。本組患者PCI術(shù)后6個(gè)月IS較術(shù)后7 d降低2%~5%,中位數(shù)為3%。以PCI術(shù)后6個(gè)月IS較術(shù)后7 d降低幅度的中位數(shù)為界值將本組患者分為IS明顯降低組(降低幅度≥中位數(shù))21例和IS無明顯降低組(降低幅度中位數(shù))39例,其中分別有0、7例患者隨訪過程中發(fā)生MACE,兩組MACE發(fā)生率相比,P0.05。結(jié)論 STEMI患者PCI術(shù)后6個(gè)月左心室GLS和IS低于術(shù)后7 d;STEMI患者PCI術(shù)后左心室GLS、IS有較好的相關(guān)性;STEMI患者PCI術(shù)后左心室GLS、IS明顯降低者不易發(fā)生MACE。
[Abstract]:Objective to observe the changes of left ventricular global longitudinal strain (GLS) and myocardial infarction area (ISI) in patients with acute ST-segment elevation myocardial infarction (STEMI) 6 months after PCI. To explore the relationship between the two factors and the occurrence of major adverse cardiovascular events in 6 ~ 12 months after PCI. Methods A total of 60 patients with STEMI after PCI (7 patients with PCI 6 ~ 12 months after MACE).PCI) were selected to measure the left ventricular GLSs by two dimensional echocardiographic dot-tracing imaging and delayed enhanced cardiac magnetic resonance imaging at 6 months. Results on the 7th day and 6th month after PCI, the GLS of left ventricle was -14% 鹵3% and 17% 鹵3%, respectively. The GLS of left ventricle was 23% 鹵7% 鹵6%. The GLSI is of left ventricle in 6 months after PCI was lower than that in 7 days after PCI (P < 0.05). Correlation analysis showed that there was a negative correlation between left ventricular GLS and is after PCI. The left ventricular GLS at 6 months after PCI was significantly lower than that at 7 days after PCI, with a median of 3. At 6 months after PCI, left ventricular GLS was divided into two groups: GLS decreased significantly (n = 26) and GLS was not significantly decreased (n = 34). Among them, there were 7 cases of MACEE during follow-up. The incidence of MACE in the two groups was higher than that in the control group (P 0.05). The is of 6 months after PCI was 2 and 5 lower than that of 7 days after PCI, with a median of 3. According to the median value of the decrease of is at 6 months after PCI compared with that on the 7th day after PCI, the patients were divided into two groups: 21 patients with significant reduction of is (reduction 鈮，

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