老年急性ST段抬高型心肌梗死患者不同时机行经皮冠状动脉介入支架植入疗效及心血管不良事件对比

Comparison of Percutaneous Coronary Interventional Stent Implantation at Different Time and Cardiovascular Adverse Events in Elderly Patients with Acute ST-segment Elevation Myocardial Infarction

目的:观察老年急性ST段抬高型心肌梗死患者在不同时机下行经皮冠状动脉介入支架植入治疗后心脏功能的改善情况,并对比分析两组患者治疗后心血管不良事件的发生率。方法:选取2012年2月-2018年2月收治的300例急性心肌梗死患者,进行临床研究。观察组(n=150)为病发6 h内给予经皮冠状动脉介入支架植入治疗的患者,对照组(n=150)为病发6～12 h给予经皮冠状动脉介入支架植入治疗的患者,对比分析不同时机治疗后上述两组患者的心脏功能改善情况和心血管不良事件发生率。结果:两组在支架植入前一般情况对比差异无统计学意义(P>0.05)。治疗前两组左室相关功能指标对比差异无统计学意义(P>0.05);治疗后观察组左室相关功能指标与对照组相比明显改善,且观察组治疗后的心血管不良事件发生率与对照组相比明显低,差异均有统计学意义(P<0.05)。结论:老年急性ST段抬高型心肌梗死患者发病后6 h内立即实施经皮冠状动脉介入支架植入治疗效果明显优于6～12 h的治疗效果,且能够在有效改善患者的左心室功能同时有效降低患者术后心血管不良事件发生率,对临床上延长患者寿命和提高患者术后生活质量具有重要意义,具有显著的临床应用价值。

Objective：To observe the improvement of cardiac function in elderly patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention with different time,and to compare the incidence of cardiovascular adverse events after treatment in the two groups. Method：A total of 300 patients with acute myocardial infarction admitted from February 2012 to February 2018 were enrolled in the clinical study.The observation group was treated with percutaneous coronary interventional stent implantation within 6 hours after the onset of the disease.The control group was treated with percutaneous coronary interventional stent implantation within 6-12 h of the disease.The function improvement and incidence of cardiovascular adverse events in two groups were studied.Result：There was no significant difference between the observation group and the control group before stent implantation（P〈0.05）.There was no significant difference in the left ventricular function between the observation group and the control group before stent implantation（P〉0.05）.After treatment,the left ventricular function index of the observation group was significantly improved compared with the control group,and the incidence of cardiovascular adverse events in the observation group was significantly lower than that of the control group,and the difference was statistically significant（P〈0.05）.Conclusion：The treatment of elderly patients with acute ST-segment elevation myocardial infarction within 6 h after onset of percutaneous coronary intervention is significantly better than the treatment within 6-12 h,and can effectively improve the left ventricular function of patients,effectively reducing the incidence of postoperative cardiovascular adverse events in patients.It is of great significance for prolonging the life span of patients and improving the quality of life of patients after surgery.It has significant clinical application value.