间歇性低氧治疗对急性ST段抬高型心肌梗死患者PCI术后预后的影响

Prognosis effect of intermittent hypoxic adaptation in treating patients with ST-segment elevation myocardial infarction after PCI

目的探讨间歇性低氧治疗对急性ST段抬高型心肌梗死患者PCI术后的心功能及预后的影响。方法选取2016年1月~2017年5月河北省直属机关第二门诊部收治的60例急性ST段抬高型心肌梗死患者,均行PCI术,随机数字表法分为对照组和观察组,每组各30例。术后两组均给予常规西药治疗,观察组在此基础上进行间歇性低氧治疗,对照组进行常氧环境治疗,均持续治疗6个月。比较两组患者治疗后心率、血压、血红蛋白、红细胞变化情况及左室射血分数(LVEF)、左心室收缩末期内径(LVDS)、左室舒张末内径(LVDD)和心脏事件发生情况。结果两组心率、血红蛋白和红细胞计数比较,差异无统计学意义(P>0.05)。治疗1、6个月后观察组收缩压和LVEF高于对照组,LVDS、LVDD低于对照组,差异均有统计学意义(P<0.05)。结论间歇性低氧可促进急性心肌梗死后损伤心肌细胞的修复,改善损伤心肌的收缩能力,促进心肌微循环,抑制梗死后心室重构。

Objective To discuss Lhe effecL of inLermiLLenL hypoxic adapLaLion on cardiac funcLion and prognosis of pa-LienLs wiLh ST-segmenL elevaLion myocardial infarcLion afLer PCI.Methods All Lhe 60 paLienLs wiLh ST-segmenL eleva-Lion myocardial infarcLion afLer PCI were LreaLed in Lhe Second Policlinic DirecLly under Lhe AuLhoriLy of Hebei Province from January 2016 Lo May 2017 selecLed and divided inLo conLrol group(n=30)and observaLion group(n=30)by random number Lable.Based on Lhe sLandard Lherapy,Lhe observaLion group was LreaLed by hypoxia inLerrupLed and Lhe conLrol group was LreaLed by regular oxygen Lherapy,Lhey were LreaLed for 6 monLhs.The hearL raLe,blood pressure,Hemoglobin,red blood cell,lefL venLricular ejecLion fracLion(LVEF),lefL venLricular end sysLolic dimension(LVDS),lefL venLricular end diasLolic diameLer(LVDD)and cardiac evenLs were compared.Results There was no sig-nificanL difference in hearL raLe,hemoglobin and RBC counL beLween Lhe Lwo groups(P>0.05).Al one and six monLhs afLer LreaLmenL,sysLolic blood pressure and LVEF in Lhe observaLion group were higher Lhan Lhose in Lhe conLrol group,and LVDS and LVDD was lower Lhan Lhose in Lhe conLrol group,wiLh sLaLisLical significance difference(P<0.05).Conclusion InLermiLLenL hypoxic adapLaLion is beneficial Lo Lhe repair of damaged myocardial cells.Besides,iL can im-prove Lhe abiliLy of myocardium conLracLion,promoLe myocardial microcirculaLion and inhibiL venLricular remodeling afLer myocardial infarcLion.