老年急性心肌梗死患者二级预防干预前后脉搏波传导速度的变化

Changes of pulse wave velocity before and after secondary prevention in elderly patients with acute myocardial infarction

目的探讨老年急性心肌梗死(acute myocardial infarction,AMI)患者二级预防对臂踝脉搏波传导速度(Brachialankle pulse wave vclocity,BaPWV)的影响。方法选择老年AMI患者256例(AMI组)二级预防规范化治疗6个月后,重复测量患者血压、血脂、心率、血糖和BaPWV;另选择同期体检者272例为对照组。对比分析二级预防前后AMI患者血压、心率、血脂、血糖和RaPWV的变化。结果与对照组比较,AMI组患者血压、心率、TC、LDL-C和RaPWV明显升高,差异有统计学意义(P<0.05);AMI组患者二级预防6个月后血压、心率、TC、LDL-C、左心室舒张末容积、左心室收缩末容积和BaPWV明显降低,LVEF明显升高,差异有统计学意义(P<0.05)。结论规范的二级预防能够有效降低老年AMI患者的BaPWV,改善动脉顺应性。

Objective To study the changes of pulse wave velocity after secondary prevention in elderly patients with acute myocardial infarction（AMI）. Methods 256 elderly patients with AMI were treated with secondary prevention, The levels of blood lipid, blood glucose, blood pressure, heart rate and braehial ankle pulse wave velocity（BaPWV） were measured at the time in hospital and after 6 months. Other selected 272 persons receiving normal physical examination served as control group. Results Compared with control group, the blood pressure, heart rate, blood total cholesterol,low-density lipoprotein cholesterol and BaPWV in AMI group were obviously higher, with significant statistical difference （P ~ 0.0,5）. After treatment for 6 months, the blood pres- sure,heart rate, the level of blood total cholesterol, low-density lipoprotein cholesterol, left ventricular end-diastolic volume,left ventricular end-systolic volume and BaPWV were decreased significantly,while left ventricular ejection fraction was obviously increased in AMI group,with sig- nificant statistical difference （P 〈 0. 05）. Conclusion The secondary prevention in elderly patients with AMI can decrease pulse wave velocity and impove elasticity of large arteries.