目的 比较非ST段抬高急性冠脉综合征 (Non-ST-segment elevation acute coronary syndrome,NSTE-ACS)患者在不同时间窗行经皮冠状动脉介入术(percutaneous coronary intervention, PCI)对左室心功能的影响。方法 选择NSTE-ACS入院且符合条件入组的患者101例。随机数字表法分为两组,早期(24～48 h)介入治疗组(49例)和延迟(≥48 h)介入治疗组(52例)。比较患者的基本临床特点、冠脉病变情况、治疗经过及结果,术前左室舒张末径(left ventricular end-diastolic diameter,LVDd)、左室射血分数(left ventricular ejection fraction,LVEF)来评价不同的介入治疗时间窗对术后生活质量、患者心功能及心肌重构的影响。结果 两组患者的临床特征、冠脉病变特点、LVDd、LVEF均无统计学意义。术后180 d早期介入治疗组与延迟介入治疗组LVDd [(50.83 ±5.02) vs (52.15±4.79)]、LVEF　[(60.98±7.06) vs (57.24±7.08)]相比,早期介入治疗组明显优于延迟介入治疗组,差异有统计学意义(P<0.05)。结论 与延迟介入治疗相比,早期介入治疗有利于急性NSTE-ACS的左室功能恢复,且随着随访时间延长,效果更好。

Objective To compare the clinical efficacy among the patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) who have undergone percutaneous coronary intervention (PCI) at the different time windows, and to investigate the left ventricular cardiac function undergoing the interventional therapy at the different time windows. Methods 101 eligible patients admitted into hospital due to NSTE-ACS were recruited Randomized grouping study was used. All patients eligible and having agreed to undergo the interventional therapy were divided into two groups by means of random number table, i.e. early (24-48 h) interventional therapy group(49 cases)and delayed (≥48 h) interventional therapy group(52 cases), their basic clinical characteristic pathological changes and therapeutic processes were compared. And as a result of comparsion of their blood flow ,LVDd and LVEF in the two groups after treatment, the effects on their living quality, cardiac function and myocardial remodeling after interventional therapy at the different time windows were assessed. Results The clinical characteristics, coronary pathological changes, intraoperative complications, incidence of postoperative cardiac insufficiency, preoperative LVDd [(50.83±5.02) vs (52.15±4.79)] and LVEF [(60.98±7.06) vs (57.24±7.08)] among the patients of the two groups undergoing interventional therapy were of no statistical difference. The preoperative LVDd was not significant in the early interventional therapy group and the delayed interventional therapy group. As shown in the Results 180 days after intervention, the interventional therapy group had better LVDd with statistical significance (P＜0.05). Conclusions As compared with the delayed interventional therapy group, the early interventional therapy of NSTE-ACS improves the clinical symptoms, shortens the hospital stay and restores the left ventricular function significantly. With the follow-up prolonged, the left ventricular function and ejection fraction are significantly improved.