直接PCI治疗对高龄急性心肌梗死患者心室慢性重构的影响

Effect of direct PCI on ventricular remodeling in elderly patients with acute myocardial infarction

目的探究直接PCI治疗对高龄急性心肌梗死患者心室慢性重构的影响。方法选择2014年7月至2015年7月我院收治的88例老年心肌梗死者为研究对象,依照就诊顺序将其随机均分成观察组与对照组,每组44例。对照组实施常规药物治疗,观察组实施直接PCI治疗,对两组患者的超声心动图与BNP、CK、CK-MB及hs-CRP水平进行对比观察。结果治疗后,观察组患者的室壁运动指数、球形指数、左心室短轴直径、左心室长轴直径、左心室射血分数、舒张末左心室容积、收缩末左心室容积、E峰减速时长、E/A和左心室舒张末内径显著优于对照组,差异有统计学意义(P<0.05);观察组的CK,CK-MB,BNP与hs-CRP值显著低于对照组,差异有统计学意义(P<0.05)。结论对于高龄心肌梗死患者,使用直接PCI治疗能够全面改善患者心室重构,降低病灶扩张率和心衰发生率,临床效果相对显著,值得进一步推广使用。

Objective To explore the effect of direct PCI on ventricular remodeling in elderly patients with acute myocardial infarction. Methods A total of 88 elderly patients with myocardial infarction in our hospital from July 2014 to July 2015 were selected as the study objects, and they were randomly divided into observation group and control group according to the order of treatment, with 44 cases in each group. The control group adopted routine drug treatment, while the observation group implemented direct PCI treatment, then the echocardiography and the levels of BNP, CK, CK-MB and hs-CRP in the two groups were observed and compared. Results After treatment, the ventricular motion index, spherical index, left ventricular short axis diameter, left ventricular long axis diameter, left ventricular ejection fraction, left ventricular end-diastolic volume, left ventricular end-diastolic volume, E peak deceleration time, E/A and left ventricular end diastolic diameter of the observation group were significantly better than those of the control group, the differences were statistically significant（P〈0.05）. The levels of CK, CK-MB, BNP and hs-CRP in the observation group were significantly lower than those in the control group（P〈0.05）. Conclusion For elderly patients with myocardial infarction, using direct PCI treatment can improve the patients＇ ventricular remodeling, reduce lesion expansion rate and the incidence of heart failure. The clinical effect is relatively significant, which is worthy of further promotion.