摘要
目的探讨不同治疗时间窗急性前壁心肌梗死急诊冠脉介入治疗对其效果的影响。方法选取2021年1月—2022年12月江南大学附属医院行急诊冠脉介入治疗的140例急性前壁心肌梗死患者,其中70例患者发病后至急诊冠脉介入治疗时间<3 h作为<3 h组,70例患者发病后至急诊冠脉介入治疗时间为3~8 h作为3~8 h组。术后,复查冠脉造影观察病变血管狭窄程度改善情况,评估治疗效果。结果<3 h组总有效率(98.57%,69/70)高于3~8 h组(84.29%,59/70)(P<0.05)。<3 h组治疗后心肌损害指标低于3~8 h组(P<0.05)。<3 h组治疗后左心室收缩末期内径、左心室舒张末期内径、左心房内径少于3~8 h组(P<0.05),左心室射血分数(52.36±4.24)%、二尖瓣口舒张早期血流速度峰值/舒张晚期血流速度峰值(early diastolic peak blood flow velocity of mitral valve opening/late diastolic peak blood flow velocity,E/A)(1.33±0.18)高于3~8 h组[(47.13±5.16)%、(1.29±0.20)](P<0.05)。随访6个月,2组均未见病死者;<3 h组心绞痛、心律失常、心源性休克等不良心血管事件发生次数均低于3~8 h组(P<0.05)。结论急性前壁心肌梗死发病早期尽早实施冠脉介入治疗,可改善患者预后,临床效果更佳。
Objective To explore the impact of emergency coronary intervention treatment on the efficacy of acute anterior wall myocardial infarction at different treatment time windows.Methods A total of 140 patients with acute anterior wall myocardial infarction who underwent emergency coronary intervention treatment at Affiliated Hospital of Jiangnan University from January 2021 to December 2022 were selected.Among them,70 patients had a duration of<3 hours from onset to emergency coronary intervention treatment as the<3 h group,and 70 patients had a duration of 3-8 h from onset to emergency coronary intervention treatment as the 3-8 h group.After operation,coronary angiography was reviewed to observe the improvement of the degree of stenosis of the diseased vessels and evaluate the therapeutic effect.Results The total effective rate of the<3 h group(98.57%,69/70)was higher than that of the 3-8 h group(84.29%,59/70)(P<0.05).The levels of myocardial damage indicators in the<3 h group after treatment were lower than those in the 3-8 h group(P<0.05).The left ventricular end systolic diameter,left ventricular end diastolic diameter,and left atrial diameter in the<3 h group were lower than those in the 3-8 h group(P<0.05).After treatment,the left ventricular ejection fraction(52.36±4.24)% and early diastolic peak blood flow velocity of mitral valve opening/late diastolic peak blood flow velocity(E/A)(1.33±0.18)were higher than those in the 3-8 h group[(47.13±5.16)%,(1.29±0.20)](P<0.05).Following up for 6 months,no deaths were found in both groups.The incidence of adverse cardiovascular events such as angina,arrhythmia,and cardiogenic shock in the<3 h group was lower than that in the 3-8 h group(P<0.05).Conclusion Early implementation of coronary intervention therapy after acute anterior wall myocardial infarction can improve the patient's prognosis and clinical outcomes.
作者
李钰
陈寒艳
林桂芬
LI Yu;CHEN Hanyan;LIN Guifen(Department of Emergency Internal Medicine,Affiliated Hospital of Jiangnan University,Wuxi Jiangsu 214062,China)
出处
《中国卫生标准管理》
2024年第2期121-125,共5页
China Health Standard Management
关键词
不同时机
时间窗
急性前壁心肌梗死
急诊
冠脉介入
左心室射血分数
different timing
time window
acute anterior wall myocardial infarction
emergency treatment
coronary intervention
left ventricular ejection fraction
