ST段抬高型心肌梗死患者择期PCI术后左心功能及血尿酸水平的研究

Investigation of left heart function and level of serum u(?)acid in patients with STEMI after PCI treatment

目的通过左室射血分数及血尿酸水平的检测评价ST段抬高型心肌梗死(STEMI)患者择期PCI的临床价值。方法对93例STEMI患者常规行择期PCI术,然后与同期静脉溶栓成功后药物治疗的80例患者对照,观察住院期间和随访3年的心脏不良事件、超声心动图及血尿酸水平的对比变化。结果对于STEMI患者静脉溶栓后7～30d,经择期PCI治疗手术成功率高,围手术期未见死亡,住院期间及随访期间PCI治疗组与药物治疗组相比再次心肌梗死的发生率下降(P<0.05),住院期间心血管病死率下降有统计学差异(P<0.05)。随访3年心血管病死率、左心功能和血尿酸水平未见显著差异(P>0.05)。结论 STEMI患者择期PCI可防止再梗死的发生以及住院期间的病死率,但随访3年的病死率、左心功能和血尿酸水平与药物治疗无显著差异。

Objective To evaluate the clinical value of PCI treatment in patients with STEMI by evaluating left ventricular ejection fraction and level of serum uric acid.Methods 93 patients with ST segment elevation myocardial infarction underwent selective PCI,and 80 patients with drug treatment after the success of intravenous thrombolytic treatment over the same period during hospitalization were enrolled as control group.The adverse cardiac events,echocardiography,and blood uric acid levels were observed and followed up 3 year.Results For patients with STEMI,from 7 to 30 days after intravenous thrombolytic treatment,selective PCI surgery had highly successful rate,the peri-operative death in the patients was not found. Compared with the drug treatment group,the incidence of reoccur of myocardial infarction was lower in PCI treatment group during hospitalization and follow up（P 0.05）,cardiovascular mortality in patients with different treatment methods had significant differences during hospital（P 0.05）.In the three years follow up there was no significant difference in mortality,left ventricular function and serum uric acid level of the two groups（P 0.05）.Conclusion Routine selective PCI in patients with STEMI can prevent their reoccur of myocardial infarction and mortality during hospitalization.But the mortality,left ventricular function and serum uric acid levels between the two groups were not significant different during 3 years follow up.