Objective To analyses the effects on left ventricular remodeling and heart function of primary and delayed PCI in acute myocardial infarction by contrast. Method The clinical data of 108 patients with acute myocardial infarction in our hospital from January 2012 to December 2015 was collected. All patients were divided into three groups according to treatments: the primary group(n=38) with primary PCI treatment; the delayed group(n=34) with delayed PCI treatment; the control group(n=36) with conservative treatment. The LAd, ESV, EDV, LVEF of the three groups in one week and 6 months after therapy were detected and compared. Then hemodynamic parameters, such as mPAP and mMPG of the three groups in one week and 6 months after therapy were collected, and recurrence of the three groups in 6 months after therapy were evaluated. Result In primary group and delayed group at 6 months after therapy, the LAd, ESV, EDV were apparently lower then these in control group, and LAd(34.04±5.10 mm), ESV(46.01±15.40 ml), EDV(114.24±25.68 ml) of primary group were lower then these of delayed group, P<0.05; The LVEF of primary group and delayed group in 6 months after therapy were statistically higher then these in control group, and LVEF(60.41±10.06%) of primary group were higher then that of delayed group, P<0.05; The mPAP and mMPG of primary group and delayed group in 6 months after therapy were markedly lower then these in another group, and mPAP(4.36±0.51 P/kD) and mMPG(0.98±0.36 P/kD) of primary group were remarkably lower then these of delayed group, P<0.05; Recurrences of AMI(7.89%) and heart failure(2.63%) of primary group were evidently lower then these of control group, P<0.05. Conclusion The primary and delayed PCI both can improve left ventricular remodeling and heart function of acute myocardial infarction, and the primary PCI can get better effects.%目的 比较直接和延迟经皮冠状动脉介入术(PCI)对急性心肌梗死(AMI)后左室重构及心功能的影响.方法 纳入2012年1月~2015年12月于重庆市开州区人民医院收治的108例AMI患者临床资料,按照治疗措施不同分为3组,直接组38例(行直接PCI治疗),延迟组35例(行延迟PCI治疗),对照组36例(行保守治疗).测定三组患者AMI治疗后1周、6个月的左室收缩末期容积(ESV)、左房内径(LAd)、舒张末期容积(EDV)、左室射血分数(LVEF),观测AMI后1周、6个月时血流动力学指标:肺动脉平均压(mPAP)、平均二尖瓣压力差(mMPG),并记录患者6个月内复发情况.结果 治疗后6个月,直接组和延迟组LAd、ESV、EDV 均低于对照组,且直接组LAd(34.04±5.10)mm、ESV (46.01±15.40)ml、EDV(114.24±25.68)ml均较延迟组低,各组间比较差异均具有统计学意义(P<0.05);直接组和延迟组治疗后6个月LVEF均显著高于对照组,且直接组LVEF(60.41%±10.06%)高于延迟组,差异具有统计学意义(P<0.05);治疗后6个月直接组和延迟组mPAP、mMPG均低于对照组,且直接组mPAP(4.36±0.51)P/kD、mMPG(0.98±0.36)P/kD低于延迟组(P<0.05);直接组在治疗后6个月内AMI再次发作7.89%,心力衰竭再住院2.63%,均显著低于对照组(P<0.05).结论 直接和延迟PCI治疗均可改善AMI患者左室重构和心功能,且直接PCI效果更佳.
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