溶栓后转运与直接转运急诊PCI治疗ST段抬高型急性心肌梗死的对照研究

A Comparative Study of Transfusion and Direct Transfusion for Emergency PCI in the Treatment of ST-segment Elevation Acute Myocardial Infarction

目的分析溶栓后转运与直接转运急诊PCI治疗ST段抬高型急性心肌梗死的效果。方法研究阶段为2017年6月—2018年6月,共纳入研究对象70例,均为ST段抬高型急性心肌梗死患者开展回顾性分析,将溶栓后转运患者(n=35)作为对照组,将直接转运急诊PCI治疗患者(n=35)作为观察组,比较两组临床效果。结果两组治疗后3dLVESD、LVEDD、LVEF差异无统计学意义(P>0.05);治疗80d后,观察组LVESD(37.21±2.52)mm、LVEDD(41.29±2.98)mm、LVEF(55.63±9.15)%改善优于对照组LVESD(42.32±2.87)mm、LVEDD(53.30±6.01)mm、LVEF(47.11±7.68)%,差异有统计学意义(t=5.638、6.002、7.025,P<0.05)。对照组不良心血管事件发生28.57%(10/35)、再住院率42.86%(15/35),观察组不良心血管事件发生8.57%(3/35)、再住院率11.43%(4/35),观察组明显低于对照组,差异有统计学意义(χ^2=8.662,P<0.05)。结论针对ST段抬高型急性心肌梗死患者采用直接转运PCI治疗方案可获得良好疗效,改善患者心功能及预后,值得临床应用与推广。

Objective To analyze the effect of transfusion and direct transfusion for emergency PCI in the treatment of ST-segment elevation acute myocardial infarction.Methods The study period was from June 2017 to June 2018.A total of 70 subjects were enrolled in the study.All patients with ST-segment elevation acute myocardial infarction underwent retrospective analysis.The patients after thrombolysis were transported(n=35),as the control group,patients who underwent emergency PCI treatment(n=35)were directly treated as observation group,and the clinical effects of the two groups were compared.Results There was no significant difference in LVESD,LVEDD,and LVEF between the two groups at 3 days after treatment(P>0.05).After 80 days of treatment,the observation group had LVESD(37.21±2.52)mm,LVEDD(41.29±2.98)mm,and LVEF(55.63±9.15)%.The improvement was better than the control group LVESD(42.32±2.87)mm,LVEDD(53.30±6.01)mm,LVEF(47.11±7.68)%,and the difference was significant(t=5.638,6.002,7.025,P<0.05).In the control group,the incidence of adverse cardiovascular events was 28.57%(10/35),and the rate of rehospitalization was 42.86%(15/35).In the observation group,8.57%(3/35)of adverse cardiovascular events occurred,and the rate of rehospitalization was 11.43%(4/35).The observation group was significantly lower than the control group,and the difference was statistically significant(χ^2=8.662,P<0.05).Conclusion Direct delivery of PCI in patients with ST-segment elevation acute myocardial infarction can achieve good results and improve cardiac function and prognosis.It is worthy of clinical application and promotion.