文章摘要
徐帝非,郭 俊,肖 婷,曾振宇,沈 建,赵仙先.二尖瓣返流患者PCI术后的短期随访研究[J].,2017,17(18):3462-3466
二尖瓣返流患者PCI术后的短期随访研究
A Short-term Follow-up Study on the Patients with Mitral Regurgitation after PCI
投稿时间:2017-02-22  修订日期:2017-03-16
DOI:10.13241/j.cnki.pmb.2017.18.013
中文关键词: 冠状动脉  介入治疗  缺血性二尖瓣返流
英文关键词: Coronary artery  Interventional therapy  Ischemia mitral regurgitation
基金项目:国家自然科学基金项目(81370493)
作者单位E-mail
徐帝非 第二军医大学附属长海医院心血管内科 上海 200433 470944763@qq.com 
郭 俊 第二军医大学附属长海医院心血管内科 上海 200433  
肖 婷 第二军医大学附属长海医院心血管内科 上海 200433  
曾振宇 第二军医大学附属长海医院心血管内科 上海 200433  
沈 建 第二军医大学附属长海医院心血管内科 上海 200433  
赵仙先 第二军医大学附属长海医院心血管内科 上海 200433  
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中文摘要:
      摘要 目的:研究PCI治疗缺血性二尖瓣返流患者的临床疗效。方法:入选2015年3月至2016年8月在第二军医大学附属长海医院心血管内科确诊为冠状动脉粥样硬化性心脏病并植入支架(不包括急诊PCI、风湿性心脏病、心梗病史)的患者100例,将其分为无返流、轻度返流及中重度返流三组,对行PCI患者的术前与术后三月复查心脏彩超结果进行对比。结果:三组之间LVEF差异明显(62.57±2.76% vs 60.47±6.75% vs 48.54±9.96, p<0.001);但各组之间的病变血管分布及支架植入个数比较差异并无明显统计学意义(P>0.05);PCI术后二尖瓣返流改善值为(-0.43±0.51 mL vs 0.58±1.65 mL vs 4.27±5.12 mL,p<0.001);LVEF变化值分别为(-0.13±3.05% vs 1.52±4.13% vs 6.23±6.87%,p<0.001)。中重度返流患者PCI血运重建后返流量相对于轻度返流和无返流的患者明显减少(4.27±5.12 mL vs 0.58±1.65 mL,p<0.001;4.27±5.12 mL vs -0.43±0.51 mL,p<0.001),轻度返流组术后二尖瓣返流及LVEF较无返流组无明显改变(p>0.05)。结论:LVEF和二尖瓣返流程度密切相关,而PCI对于重度缺血性二尖瓣返流疗效较好,但并未发现冠脉病变分布上及支架植入个数的差异。
英文摘要:
      ABSTRACT Objective: Study on PCI for clinical curative effect for ischemic mitral regurgitation patients. Methods: selected from March 2015 to August 2016 in the cardiovascular department of Changhai Hospital Affiliated to Second Military Medical University for diagnosis of coronary atherosclerotic heart disease and stent implantation (not including emergency PCI, rheumatic heart disease, myocardial infarction) in 100 cases of patients, which is divided into no reflux, mild reflux flow and severe back flow group, patients with PCI before and after the March review of echocardiographic findings were compared. Results: LVEF significant differences between the three groups (62.57 + 2.76% vs 60.47 + 6.75% vs 48.54 + 9.96, P < 0.001); but among the groups in the distribution of vascular lesions and stent implantation number had no significant difference; after PCI to improve the value of mitral regurgitation (-0.43 + 0.51 mL for vs 0.58 + 1.65 mL vs 4.27 + 5.12 mL, P < 0.001); the change of LVEF = (-0.13 + 3.05% vs 1.52 + 4.13% vs 6.23 + 6.87%, P < 0.001). Severe regurgitation in patients with PCI after revascularization compared with light; the degree of reflux and reflux with return flow was significantly reduced (4.27 + 5.12 mL vs 0.58 + 1.65 mL, P < 0.001; 4.27 + 5.12 mL vs -0.43 + 0.51 mL, P < 0.001), mild regurgitation after mitral regurgitation and LVEF compared with non reflux group had no obvious change. Conclusion: LVEF and mitral regurgitation is closely related, and PCI for severe ischemic mitral regurgitation curative effect is good, but did not find a difference in distribution of coronary artery lesions and stent implantation number.
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