溶栓后转运PCI与PCI对急性心肌梗死合并COPD患者的临床疗效比较

Comparison of Clinical Efficacy Between PCI and PCI After Thrombolysis in Patients With Acute Myocardial Infarction Complicated With COPD

目的比较溶栓后转运PCI与PCI对急性心肌梗死合并肺部感染患者的临床疗效。方法随机选取2010年1月—2019年1月在华中科技大学同济医学院附属协和医院心血管内科病房进行急性心肌梗死合并肺部感染治疗的患者150例进行临床研究,根据转运至我院行PCI治疗前是否给予溶栓治疗分为观察组66例和对照组84例,对照组患者确诊后直接转运PCI,观察组患者在转运PCI前给予溶栓治疗,比较两组患者治疗前和治疗后7 d心功能、炎症因子的变化情况,并观察两组患者术后心性死亡、再梗死、心源性休克、心功能不全、心绞痛等心血管不良事件发生率。结果两组患者治疗前LVEDD、LVESD、LVEF差异无统计学意义(P>0.05),治疗后两组患者上述指标与治疗前均有明显改善(P<0.05),但观察组患者LVEDD、LVESD明显低于对照组,LVEF明显高于对照组,且差异具有统计学意义(P<0.05),两组患者治疗前PCT、CRP差异无统计学意义(P>0.05),治疗后两组患者上述指标与治疗前均有明显改善(P<0.05),但观察组患者PCT、CRP明显低于对照组(P<0.05),观察组患者不良事件发生率为6.06%,明显低于对照组19.05%(P<0.05)。结论对于急性心肌梗死合并肺部感染患者给予溶栓后转运PCI能够明显改善患者的心功能,降低患者炎症因子水平,并且降低术后不良事件发生率。

Objective To compare the clinical effects of transporting PCI and PCI after thrombolysis in patients with acute myocardial infarction complicated with pulmonary infection.Methods From January 2010 to January 2019,150 patients with acute myocardial infarction complicated with pulmonary infection were randomly selected in the Department of Cardiovascular Medicine,Union Medical College Affiliated to Tongji Medical College,Huazhong University of Science and Technology..According to whether thrombolytic therapy was given before PCI,they were divided into observation group(66 cases)and control group(84 cases).The patients in control group were directly transported to PCI after diagnosis.The patients in observation group were given thrombolytic therapy before PCI.The patients in observation group were compared between the two groups.The changes of cardiac function and inflammatory factors were observed before and 7 days after treatment.The incidence of cardiovascular adverse events such as cardiac death,re-infarction,cardiogenic shock,cardiac insufficiency and angina pectoris was also observed.Results There was no significant difference in LVEDD,LVESD and LVEF between the two groups before treatment(P>0.05).After treatment,the above indexes of the two groups were significantly improved(P<0.05).However,the LVEDD and LVESD of the observation group were significantly lower than those of the control group,and the LVEF of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in PCT and CRP between the two groups before treatment(P>0.05).After treatment,the above indexes of the two groups were significantly improved(P<0.05),but PCT and CRP in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse events in the observation group was 6.06%,which was significantly lower than that in the control group(19.05)(P<0.05).Conclusion PCI after thrombolysis can significantly improve cardiac function,reduce the level of inflammatory factors and reduce the incidence of adverse events in patients with acute myocardial infarction complicated with pulmonary infection.