作　　者： ; ; ; ; ;

机构地区： 佛山市第一人民医院

出　　处： 《广东医科大学学报》 2019年第2期111-113,共3页

摘　　要： 目的观察急性ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗(PPCI)前后阻抗心动描记法(ICG)血流动力学指标的变化。方法诊断为急性ST段抬高型心肌梗死的患者230例,其中132例(PPCI组)以PPCI治疗,98例(非PPCI组)为非PPCI治疗,应用无创血流动力学监测仪测量两组术前(入院时)及术后(治疗后)24 h、术后(治疗后)1周的心率(HR)、血压(BP)、心排量(CO)、心指数(CI)、搏出量(SV)、搏出指数(SI)、外周血管阻力(SVR)、外周血管阻力指数(SVRI)、左心做功(LCW)、左心做功指数(LCWI)、胸腔液体水平(TFC)、加速指数(ACI)、速度指数(VI)、预射血时间(PEP)、左心室射血时间(LVET)、收缩时间比率(STR)。结果 PPCI组术后24 h与术前相比,CO、CI、SV、SI、LCW、LCWI均降低(P<0.01或0.05);术后1周与术前相比,SVR、SVRI降低(均P<0.01)。术后(治疗后)1周,PPCI组与非PPCI组相比,CO、CI、SV、SI、ACI、VI增加,SVR、SVRI降低(均P<0.01或0.05)。结论急性心肌梗死患者早期可出现心功能减退,ICG有助于动态观察患者血流动力学状态,间接评估PPCI术对急性心肌梗死患者的近期疗效。 Objective To investigate the Changes in hemodynamic indexes of impedance cardiography (ICG) in patients with Acute ST-segment elevation myocardial infarction before and after primary percutaneous coronary intervention (PPCI). Methods There were 230 patients diagnosed with acute ST-segment elevation myocardial infarction,of which 132 patients (PPCI Group) were treated with PPCI and 98 patients (Non-PPCI Group) were treated with non-PPCI.The HR,BP,CO,CI, SV,SI,SVR,SVRI,LCW,LCWI,TFC,ACI,VI,PEP,LVET and STR were measured by non-invasive hemodynamic monitor before and 24 h before the operation (at admission) and 1 week after operation (after treatment).Results In PPCI Group,the CO,CI,SV,SI,LCW and LCWI decreased at 24 h after the operation compared with those before operation (P< 0.01 or 0.05), and SVR and SVRI decreased at 1 week after the operation compared with those before operation (P<0.01).At 1 week after the operation,compared with Non-PPCI Group,the PPCI Group had increased CO,CI,SV,SI,ACI and VI,and decreased SVR and SVRI (P<0.01 or 0.05).Conclusion Patients with acute myocardial infarction may have cardiac dysfunction in early stage.ICG can help to dynamically observe the hemodynamic status of patients and indirectly evaluate the short-term effect of PPCI on patients with acute myocardial infarction.

关 键 词： 阻抗心动描记法 急性心肌梗死 无创血流动力学检测

领　　域： []