急性心肌梗死患者于不同时期行PCI术对心功能及HMGB1水平的影响

The effects of emergency PCI and selective PCI on cardiac function and HMGB1 level in patients with AMI

目的 探究急性心肌梗死(AMI)患者于不同时期行经皮冠状动脉介入治疗(PCI)对心功能及高迁移率族蛋白B1(HMGB1)水平的影响.方法 回顾性选取2016年6月—2018年6月保定市第二中心医院心内科收治的85例AMI患者作为研究对象,根据行PCI术时间的不同将AMI患者进行分组,行急诊PCI术患者为对照组(n=43),择期行PCI术为观察组(n=42).入院当天及PCI术后均行心脏彩超检查,检测患者心功能,比较左心室舒张末期内径(LVIDd)、左心室收缩末期内径(LVIDs)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)及舒张早期血流峰速度(E)/舒张晚期血流峰速度(A)改变,同时测定血浆HMGB1水平.结果 入院时,两组患者心功能LVIDd、LVIDs、LVEF、LVFS、E/A值及血浆HMGB1水平的差异均无统计学意义(P>0.05).PCI术后患者心功能较入院时有所改善;对照组LVIDd和LVEF优于观察组,且血浆HMGB1含量低于观察组,差异有统计学意义(P<0.05).结论 行急诊PCI术治疗的AMI患者心功能及血浆HMGB1水平优于择期PCI患者,可能与尽早恢复血运重建,减少炎症反应有关.

Objective To explore the effects of emergency PCI and selective PCI on cardiac function and HMGB1 level in patients with AMI.Methods 85 cases of patients with acute myocardial infarction(AMI)in the department of cardiology were retrospectively chosen as the research object from June 2016 to June 2018 in the Second Central Hospital of Baoding City.Based on the PCI operation time,AMI patients underwent emergency PCI were divided into the control group(n=43),while,patients with elective PCI were selected as the observation group(n=2).Echocardiography was performed in two groups after the PCI postoperative for evaluating cardiac function,and LVIDd,LVIDs,ILVEF,LVFS and E/A changes were also com pared.In addition,plasma HMGB1 levels of two groups were determ ined.Results Before PCI,cardiac function LVIDd,LVIDs,LVEF,LVFS,E/A value and plasm a HMGB1 levels of patients in two groups had no statistical difference(P>0.05).The cardiac function of patients in two groups were improved post PCI postoperative.LVIDd and LVEF of patients in control group underwent emergency PCI were better than that in the observation group.And the plasma HMGB1 levels was also lower than that in the observation group,the difference was statistically significant(P<0.05).Conclusion The cardiac function and plasma HMGB1 level of AMI patients underwent emergency PCI were better than that of patients with elective PCI,which might be related to restore blood supply reconstruction as soon as possible and reduce inflam mation reactions.