PCI联合冠状动脉内溶栓对老年急性ST段抬高型心肌梗死患者心功能指标与不良心血管事件发生情况的影响

Effects of PCI combined with intracoronary thrombolysis on cardiac function indexes and adverse cardiovascular events in elderly patients with acute ST segment elevation myocardial infarction

目的探讨经皮冠状动脉介入术(PCI)联合冠状动脉内溶栓对老年急性ST段抬高型心肌梗死(STEMI)患者心功能指标与不良心血管事件发生情况的影响。方法回顾性分析2017年4月至2019年2月于我院行PCI治疗的198例STEMI患者的临床资料,根据治疗方法将患者分为对照组与观察组,各99例。所有患者均在PCI术中行血栓抽吸,抽吸结束后,对照组于冠脉靶病变远端给予生理盐水注射,观察组给予重组人尿激酶原注射。比较两组的临床疗效、心功能指标、术后IRA TIMI血流分级、不良心血管事件发生情况。结果观察组的治疗总有效率高于对照组(P<0.05)。治疗后30、60 d后,两组的LVEF均升高,LVEDD均减小,且观察组优于对照组(P<0.05)。观察组患者术后IRA TIMI 3级的占比高于对照组(P<0.05)。两组的不良心血管事件总发生率比较,差异无统计学意义(P>0.05)。结论PCI联合冠状动脉内溶栓治疗STEMI患者的效果显著,可有效改善心功能指标,改善血流情况。

Objective To explore the effects of percutaneous coronary intervention(PCI)combined with intracoronary thrombolysis on cardiac function indexes and adverse cardiovascular events in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods The clinical data of 198 STEMI patients who underwent PCI in our hospital from April 2017 to February 2019 were retrospectively analyzed.The patients were divided into control group and observation group by the treatment method,with 99 cases in each group.All patients were performed thrombus aspiration during PCI,after the end of aspiration,the control group was given saline injection at the distal end of coronary target lesion,and the observation group was given recombinant human prourokinase for injection.The clinical efficacy,cardiac function indexes,postoperative IRA TIMI blood flow classification and adverse cardiovascular events were compared between the two groups.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After 30 and 60 d of treatment,LVEF in the two groups increased,LVEDD decreased,and those in the observation group were better than the control group(P<0.05).The proportion of IRA TIMI grade 3 in the observation group was higher than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse cardiovascular events between the two groups(P>0.05).Conclusion PCI combined with intracoronary thrombolysis in the treatment of STEMI patients has a significant effect,which can effectively improve cardiac function indexes and blood flow.