经皮冠状动脉介入术介入时机对急性心肌梗死患者的影响

Effect of PCI timing on patients with acute myocardial infarction

目的探讨经皮冠状动脉介入术(Percutaneous coronary intervention,PCI)介入时机对急性心肌梗死患者心肌改善及主要不良心血管事件(Major adverse cardiovascular events,MACE)发生率的影响。方法选择2019年1月至2019年6月本院收治的急性心肌梗死患者200例,按照介入时机分为两组各100例。A组溶栓结束后6h内进行PCI治疗,B组溶栓结束后6~48h进行PCI治疗。比较两组心功能、心肌改善及MACE发生率。结果两组左室收缩末期内径(LVESD)、左心室收缩末期容积(LVESV)均低于治疗前,左室射血分数(LVEF)水平高于治疗前,A组上述指标变化幅度大于B组,差异有统计学意义(P<0.05);A组肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)恢复正常时间均短于B组,差异有统计学意义(P<0.05);A组MACE发生率低于B组,差异有统计学意义(P<0.05)。结论急性心肌梗死患者在溶栓结束6h内进行PCI介入治疗的效果较好,可有效改善患者心功能和心肌情况,降低MACE发生率。

Objective To investigate the effect of percutaneous coronary intervention(PCI)timing on myocardial improvement and incidence of major adverse cardiovascular events(MACE)in patients with acute myocardial infarction.Methods A total of 200 patients with acute myocardial infarction who admitted in our hospital from January 2019 to June 2019 were selected and divided into two groups according to PCI timing,with 100 cases in each group.Group A were treated with PCI within 6h after the end of thrombolysis,and group B were treated with PCI during 6-48h after the end of thrombolysis.The cardiac function,myocardial improvement and the incidence of MACE were compared between the two groups.Results The left ventricular end systolic diameter(LVESD)and left ventricular end systolic volume(LVESV)in two groups after treatment were lower than those before treatment,the left ventricular ejection fraction(LVEF)after treatment was higher than that before treatment,and the changing range of above indexes in group A was larger than that in group B(P<0.05).The recovery time of creatine kinase isoenzyme(CK-MB)and creatine kinase(CK)in group A was shorter than that in group B(P<0.05).The incidence of MACE in group A was lower than that in group B(P<0.05).Conclusion PCI within 6h after the end of thrombolysis in treatment of patients with acute myocardial infarction has better effects,it can effectively improve cardiac function and myocardial conditions,and decrease the incidence of MACE.