Application Of EVLW In Diagnosis And Treatment Of Acute Left Ventricular Failure In Patients With AMI

Objective:To investigate the value of extravascular lung water (EVLW) in the diagnosis and treatment of acute myocardial infarction complicated with acute left heart failureMethods:acute myocardial infarction were collected from May 2015 to March 2017 in cardiovascular medicine CCU Yanan hospital in Kunming city with acute left heart failure and received PICCO detection in 41 cases, record the general condition of patients, including age, gender, height, weight, ALT (Alanine aminotransferase, ALT,aspartate aminotransferase (Aspartate) transaminase,AST),blood urea nitrogen(blood urea, nitrogen, BUN), muscle Anhydride (creatinine, Cr), total cholesterol(total, cholesterol, CHOL), triglycerides (Triglyceride, TRIG); hypertension, diabetes;whether or not PTCA or PCI treatment, patients after treatment, compared with PiCCO method for the determination of extravascular lung water (EVLW) value and clinical manifestations of patients with left ventricular ejection. Ejection fraction(LVEF), chest (Fluoroscopy of chest) the degree of pulmonary edema, brain natriuretic peptide (BNP), oxygen saturation (Sp S grade and EVLW value change,EVLW value and variance analysis of pulmonary edema by chest X-ray, set a =0.05 level to P<0.05, the difference was statistically significant.Results:1. improved group EVLW values before and after treatment respectively: 14.65±3.38 ml/kg?7.51±1.86ml/kg;The death group before and after treatment,EVLW=13.26±1.64ml/kg?16.05±1.32ml/kg, P<0.01 treatment group, the difference was statistically significant, indicating improvement after treatment EVLW decreased; the death group P<0.05, the difference was statistically significant, suggesting that the death group after treatment increased EVLW value.2.the improved group,the death group before treatment,EVLW = 14.65 ±3.38ml/kg?13.26±1.64ml/kg,p>0.05,the difference was not statistically different. Before treatment, the death group EVLW value is not higher than that of the improved group.3.Killips? group EVLW was 9.24±0.43ml/kg,KillipsIII group EVLW was 11.98±1 ml/kg, Killips? group EVLW was 16.54 ± 1.49 ml/kg.Killips? level,? level,?level between the single factor analysis of variance, the results show there are differences (F=112.35, P=0.000<0.05) between the three groups; further LSD 22: the? level and ? level P=0.21>0 There was no significant difference in.05, ? level and? level, ? level and ? level were P=0.000<0.05, there were significant differences.4.chest X-ray manifestations of pulmonary congestion (light) interstitial pulmonary edema (in) alveolar pulmonary edema (RE) when EVLW = 9.54 ± 0.80ml/kg,12.61±1.15 ml/kg 17.46 ± 1.76 ml/kg. (light), pulmonary congestion, interstitial pulmonary edema (in), alveolar edema (heavy) in between the single factor analysis of variance, showed differences (F=58.186, P=0.000<0.05), between the three groups were further LSD 22: pulmonary congestion, pulmonary interstitial edema, alveolar pulmonary edema were 22 P=0 .000<0.05, the differences were statistically between the three groups.5.the linear regression equation is y=54.444-1.023x, LVEF (%) r=-0.909, p=0.000. In accordance with the inspection standards, P<0.05, the difference was statistically significant, there was a negative correlation between LVEF and EVLW.The linear regression equation is y=73.79-0.723x, Sp02 (%) r=--0.929, p=0.000. In accordance with the inspection standards, P<0.05, the difference was statistically significant, there was a negative correlation between Sp02 and EVLW.The linear regression equation is y=-3.559+0.003x, BNP r=0.993, P=0.000. According with the inspection standards,P<0.001, the difference was statistically significant,there was a positive correlation between NT-proBNP and EVLW value.The linear regression equation is y=14.55-0.005x, cTn-I r=-0.013, P=0.938.According to the test standard,P>0.05, the difference was not statistically significant,no correlation between cTn-I and EVLW.The linear regression equation is y=15.33-0.047x, CK-MB r=-0.132, P=0.946.According to the test standard, P>0.05, the difference was not statistically significant,no correlation between CK-MB and EVLW.Conclusion:1.ELVW can accurately reflect the left ventricular function in patients with acute myocardial infarction, and is an important means to determine the extent of cardiac function damage in patients with acute myocardial infarction combined with acute left heart failure2.ELVW is helpful for the treatment of acute myocardial infarction complicated with acute left heart failure.