摘要
目的观察急性ST段抬高型心肌梗死患者急诊冠状动脉介入治疗对心功能的影响。方法选择2015年1—10月鞍钢集团公司总医院心血管内科治疗的急性心肌梗死患者298例进行回顾性研究,最终按照入选标准纳入241例患者,其中观察组198例,对照组43例。对照组患者接受常规治疗,观察组患者在对照组基础上行急诊冠状动脉介入手术治疗。观察比较2组患者的临床效果、心功能指标、脑钠肽（BNP）、肌酸磷酸激酶（CK）、肌酸磷酸激酶同工酶（CK-MB）变化情况及治疗后6个月的并发症情况等。结果观察组胸部疼痛得到缓解率、心电图ST段恢复正常率均明显优于对照组（95.4%、81.3%vs.58.1%、53.5%,χ~2=16.679、7.626,P〈0.05）,心力衰竭发生率低于对照组（20.7%vs.51.2%,χ~2=8.524,P〈0.05）;LVEF水平明显高于对照组[（51.13±5.47）%vs.（49.28±6.62）%,t=1.963,P〈0.05];LVESV、LVEDV水平均明显低于对照组[（46.35±5.84）ml vs.（55.06±7.39）ml,（110.18±8.56）ml vs.（121.52±9.07）ml,t=8.430、7.790,P〈0.01];观察组BNP水平明显低于对照组[（337.42±219.68）ng/L vs.（458.37±307.74）ng/L,t=3.027,P〈0.05）],CK、CK-MB水平明显高于对照组[（5 163±3 087）U/L vs.（4 213±1 762）U/L,（569±388）U/L vs.（463±238）U/L,t=1.968、1.972,P〈0.05];观察组并发症发生率少于对照组（P〈0.05）。结论急性ST段抬高型心肌梗死患者行急诊冠状动脉介入手术治疗,能够获得良好的效果,有效改善其心功能及BNP水平,并且具有较少的并发症,值得临床推广。
Objective Analyze and investigate the influences in cardiac function of patients with acute ST segment elevation myocardial infarction in treatment with coronary intervention.Methods 298 cases of patients with acute myocardial infarction treated in General Hospital of Angang Group from January to October 201 S were taken for this study.Finally 241 cases of patients were enrolled into retrospective study according to the inclusion criteria.Therefor,198 cases were grouped in the observation group and 43 cases were grouped in the control group.The patients of control group were treated with conventional treatment.On the basis of the conventional treatment,the patients of observation group were treated with coronary intervention.The clinical effects,cardiac function,complications were observed and compared for 6 months after treatment,and the changes of BNP,CPK,CK-MB of two groups were recorded.Results After the appropriate treatment,the clinical effects of the observation group were significantly better than the control group（χ~2=16.679,χ~2 = 7.626,χ~2=8.524;P 0.05）;The levels of ESV,EDV of the observation group were significantly less than those of the control group（t = 8.430,t =7.790;P 0.05）,the levels of LVEF of the observation group were significantly higher than those of the control group（t =1.963,P 0.05）;The levels of BNP in the observation group were significantly less than those of the control group（t =3.027,P 0.05）,the levels of CPK,CK-MB in the observation group were significantly higher than those of the control group（t = 1.968,t = 1.972;P 0.05）;The complications for 6 months after treatment in the observation group were significantly less than that of the control group（χ~2 =0.003,χ~2=0.044,χ~2=0.049,χ~2=0.041;P 0.05）.Conclusion The coronary intervention for acute myocardial infarction can attain some good clinical efficacy,and effectively improve the levels of cardiac function and B type natriuretic peptide as well as reduce complications,which makes it worthy of clinical application.
出处
《疑难病杂志》
CAS
2016年第7期670-673,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
心肌梗死
急性
冠状动脉介入治疗
心功能
脑钠肽
Myocardial infarction acute
Coronary intervention
Cardiac function
B type natriuretic peptide
作者简介
通信作者：贾大林，E—mail：JDL2001@263．net
