经皮冠脉内支架植入术对冠心病心力衰竭患者心功能的影响

Effect of percutaneous coronary stent implantation on cardiac function in patients with heart failure of coronary heart disease

目的研究经皮冠状动脉支架植入术(PCI)对冠状动脉粥样硬化性心脏病(冠心病)心力衰竭(心衰)患者治疗的临床价值。方法 206例冠心病心力衰竭患者,造影结果提示有血运重建指征,依据治疗方式不同分为PCI组(164例)及药物治疗组(42例),比较两组治疗前及治疗后6个月和12个月的N末端脑钠肽前体(NT-pro BNP)、左室舒张末期内径水平。结果治疗前,两组患者的NT-pro BNP和左室舒张末期内径比较差异无统计学意义(P>0.05);治疗后6个月和12个月,PCI组患者的NT-pro BNP分别为(2160.77±1019.49)、(1527.07±786.51)pg/ml均低于药物治疗组的(2644.00±1058.26)、(3386.62±935.44)pg/m,左室舒张末期内径分别为(53.77±1.85)、(52.77±1.87)mm均小于药物治疗组的(56.38±1.93)、(57.93±2.30)mm,差异具有统计学意义(P<0.05)。治疗前、治疗后6个月和12个月,PCI组患者的NT-pro BNP和左室舒张末期内径均呈下降趋势(P<0.05)。结论 PCI提高了冠心病慢性心力衰竭患者的心功能,对改善患者预后有积极的意义。

Objective To study the clinical value of percutaneous coronary stent implantation （PCI） in the treatment of patients with heart failure of coronary atherosclerotic heart disease. Methods A total of 206 patients with heart failure of coronary heart disease, the results of the angiography indicated that there were signs of revascularization, were divided into PCI group （n=164） and drug treatment group （n=42） according to the different ways of treatment. The N-terminal pro brain natriuretic peptide （NT-proBNP）, left ventricular end diastolic diameter before treatment and after 6, 12 months of treatment between the two groups were compared. Results There were no statistically significant differences in the NT-proBNP and left ventricular end diastolic diameter between the two groups before treatment （P〉0.05）. The NT-proBNP of PCI group after 6, 12 months of treatment were （2160.77 ±1019.49） pg/ml and （1527.07 ± 786.51） pg/ml, which were significantly lower than （2644.00 ± 1058.26） pg/ml and （3386.62 ± 935.44） pg/ml of the drug treatment group, and the left ventricular end diastolic diameter of PCI group after 6, 12 months of treatment were （53.77 ± 1.85） mm and （52.77 ± 1.87） mm, which were significantly less than （56.38 ± 1.93） mm and （57.93 ± 2.30） mm of the drug treatment group, the differences were statistically significant （P〈0.05）. Before treatment, after 6 and 12 months of treatment, the NT-proBNP and left ventricular end diastolic diameter of patients in PCI group showed a decreasing trend （P〈0.05）. Conclusion PCI improves cardiac function in patients with heart failure of coronary heart disease, and has positive significance in improving prognosis of patients.