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。方法将我院收治的88例老年心肌梗死患者,随机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,随后对超声心动图进行随访,并比较两组治疗后BNP、CK、CK-MB及hs-CRP水平。结果从超声随访结果上来看,两组患者的室间隔厚度与左心室后壁厚度比较,无显著差异(P>0.05)。两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比较,差异有统计学意义(P<0.05)。治疗后,观察组的CK-MB、CK、BNP与hs-CRP水平显著低于对照组(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现象,并降低病灶扩张率和心衰发生率,临床效果显著,值得进一步推广。

Objective To explore the effect of direct PCI on ventricular remodeling in elderly patients with acute myocardial infarction. Methods Eighty-eight elderly patients with myocardial infarction in our hospital were randomly divided into observation group and control group, with 44 cases in each group. The control group was treated with conventional drugs, and the observation group was treated with direct PCI. The echocardiography was followed and the levels of BNP, CK, CK-MB and hs-CRP between the two groups were compared. Results From the results of echocardiography,the ventricular septal thickness and left ventricular posterior wall thickness in the two groups has no significant difference（P〉0.05）. The wall 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-systolic volume, E peak deceleration time, E/A and left ventricular end diastolic diameter in the two groups have statistically significant differences（ P〈0.05）.After treatment, the levels of CK-MB, CK, 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, the use of direct PCI treatment can improve the patients＇ ventricular remodeling, reduce the rate of lesion dilation and the incidence of heart failure, the clinical effect is remarkable, which is worthy of further use.