微创医学

目的探讨冠脉介入对缺血性心肌病合并左心功能不全患者的疗效。方法选取缺血性心肌病合并左心功能不全的患者110例，分为对照组51例与观察组59例，对照组给予最佳药物治疗包括培哚普利、美托洛尔、阿托伐他汀、拜阿司匹林、曲美他嗪等；观察组在药物治疗基础上给予冠脉介入治疗。随访1年，观察心绞痛发作及心功能状态（NYHA分级）以及心超变化情况。结果冠脉介入术后1年，观察组患者心绞痛发作比例明显低于对照组（P＜0.05），心功能分级Ⅰ～Ⅱ级比例高于对照组，左室射血分数、左室舒张末内径改善均优于对照组，两组比较，差异具有统计学意义（P＜0.05）。结论与药物治疗相比，冠脉介入治疗可以更好地改善合并左心功能不全的缺血性心肌病患者的心绞痛症状，改善心功能及心超各项指标。

Objective To investigate the efficacy of coronary intervention for patients with ischemic cardiomyopathy complicated with left ventricular dysfunction. Methods A total of 110 patients with ischemic cardiomyopathy complicated with left ventricular dysfunction were involved in this study, and were divided into control group (n=51) and observation group (n=59). The patients in the control group received optimal medical therapy, mainly including perindopril, metoprolol, atorvastatin, bayaspirin and trimetazidine. And the patients in the observation group underwent coronary intervention on the basis of medical therapy. During the followup of one year, the angina attack, cardiac function (assessed by NYHA classification) and echocardiographic changes were observed. Results At one year after the coronary intervention, the incidence of angina attack in the observation group was significantly lower than that in the control group (P＜0.05). Compared with the control group, the proportion of NYHA class Ⅰ to Ⅱ was higher, and the improvement of left ventricular ejection fraction and left ventricular enddiastolic diameter were superior in the observation group. there was a difference between the two groups (P＜0.05). Conclusions For the patients with ischemic cardiomyopathy complicated with left ventricular dysfunction, coronary intervention can improve symptoms of angina, heart function and echocardiographic indexes compared with the drug therapy.