急诊PCI与药物保守治疗对急性心肌梗死患者近期心功能的影响

Effect of Emergency PCI and Drug Conservative Therapy on Short-term Cardiac Function in Patients with Acute Myocardial Infarction

目的对比急诊PCI与药物保守治疗对急性心肌梗死对患者近期心功能的影响作用。方法随机抽取2011年1月—2016年1月收治的急性心肌梗死患者108例,以国际随机数字表法分为介入组和保守组,各54例患者。两组患者急诊入院后均给予常规急性心肌梗死治疗,在此基础上介入组患者实施PCI治疗,保守组患者给予皮下注射低分子肝素,联合口服氯吡格雷进行治疗。结果介入组患者的心衰、心绞痛、再次梗死等不良心脏事件发生率和死亡率,均明显低于保守组,组间比较差异显著(P<0.05)。介入组患者心脏功能分级情况,及LVEDD、LVEF等超声心动图检查指标,在治疗前与保守组相比,组间比较差异不具有显著性(P>0.05)。在治疗后与保守组相比,介入组患者心脏功能分级情况,及LVEDD、LVEF等超声心动图检查指标的改善程度均具有显著优势,组间比较差异显著(P<0.05)。结论急诊PCI治疗急性心肌梗死,较保守治疗,临床疗效更加显著,对患者近期心功能的改善效果更加优秀。

Objective To compare the PCI and emergency medicine conservative treatment of acute myocardial infarction on cardiac function in patients with recent effect. Methods Randomly selected from 108 patients with acute myocardial infarction from January 2011 to January 2016 period in our hospital in the cases,with international random number list method is divided into the intervention group and the conservative group,54 patients were given routine treatment. Two groups of patients with acute myocardial infarction after emergency admission,on the basis of the intervention group were treated with PCI treatment,conservative group were treated with subcutaneous injection of low molecular weight heparin combined with oral clopidogrel treatment. Results The intervention group of patients with heart failure,angina,re infarction and other adverse cardiac events and mortality rates were significantly lower than those of conservative group,a significant difference between the two groups（ P〈0. 05）. Intervention group classification,cardiac function and LVEDD,LVEF echocardiography index,compared with the conservative group before treatment,the difference between groups is not significant（ P〈0. 05）. After treatment compared with the conservative group,intervention group patients with heart function classification,and improve the degree of LVEDD,LVEF echocardiography index has significant advantages,significant difference between the two groups（ P〈0. 05）. Conclusions The emergency PCI treatment of acute myocardial infarction is more conservative than the conservative treatment,the clinical effect is more significant,and the improvement of the short-term heart function is better.