预防性应用临时起搏器对急性下壁心肌梗死急诊冠状动脉介入治疗术预后的影响

Effects of Preventive Application of Temporary Pacemaker on Emergency PCI Prognosis of Acute Inferior Wall Myocardial Infarction

目的探究预防性应用临时起搏器对急性下壁心肌梗死(AIMI)急诊PCI(冠状动脉介入治疗术)预后的影响。方法择取我院2012年9月至2014年9月收治的接受急诊PCI治疗的101例急性下壁心肌梗死患者为临床研究对象,以未应用临时起搏器的79例患者为对照组,行临时起搏的22例患者为试验组,观察两组患者冠状动脉病变特征及再灌注前后血压、药物应用情况,并探究心血管事件发生状况。结果试验组心血管事件发生率(45.45%vs.56.96%)明显低于对照组,差异有统计学意义(P<0.05),再灌注后低血压发生率(40.90%vs.46.84%)与对照组比较差异无统计学意义(P>0.05),再灌注后低血压者用药率(40.90%vs.46.84%)较对照组差异无统计学意义(P>0.05),且再灌注后SBP[(93.94±27.48)mm Hg vs.(104.66±26.11)mm Hg]、DBP[(59.87±17.96)mm Hg vs.(61.58±16.20)mm Hg]均明显下降,差异有统计学意义(P<0.05)。结论临时起搏对再灌注反应无显著性保护作用,对再灌注低血压恢复及药物应用时间无明显影响,临床上应引起足够重视。

Objective To explore the application of temporary pacemaker： prevention of acute inferior myocardial infarc- tion （AIMI） and PCI（emergency coronary artery interventional therapy） prognosis. Methods Selected 101 cases of acute inferi- or myocardial infarction patients in our hospital from September 2012 to September 2014 treated in emergency PCI treatment as clinical research object,79 cases with no application of temporary pacemaker patients as control group ,22 cases of temporary cardi- ac pacing patients as experimental group, observing coronary artery disease characteristics and reperfusion blood pressure, drug appli- cation and research status, cardiovascular events of two groups. Results In experimental group, the incidence rate of cardiovascular events（45.45 % vs 56. 96% ） was significantly lower than that of the control group （P 〈 0. 05 ）, after reperfusion, hypotension rate （40. 90% vs 46. 84% ） there was no significant difference compared with control group（ P 〉 0. 05 ）, hypotension rate of medication after reperfusion （40. 90% vs 46. 84% ） had no evident change compared to control group （P 〉 0. 05 ）, SBP [ （93.94 ± 27.48 ）mmHg vs. （ 104. 66 3：26. 11 ）mmHg] ,DBP after reperfusion[ （59. 87 ±17. 96） mmHg vs. （61.58 ± 16. 20） mmHg] were significantly de- creased（P 〈 0. 05）. Conclusion Temporary pacing on reperfusion reaction had no significant protective effect, no obvious effect on the recovery of reperfusion hypotension and drug application time, clinical attention should be paid.