病发6h内经皮冠脉介入支架植入术在老年急性ST段抬高型心肌梗死患者中实施的意义

Significance of percutaneous coronary stent implantation within 6 h of disease onset in elderly patients with acute ST-segment elevation myocardial infarction

目的研究病发6 h内经皮冠脉介入支架植入术在老年急性ST段抬高型心肌梗死(STEMI)患者中实施的意义。方法将68例老年急性STEMI患者按照入院时发病时间长短分成对照组(34例,病发6~12 h给予经皮冠状动脉介入支架植入治疗)和观察组(34例,病发6 h内给予经皮冠状动脉介入支架植入治疗),比较治疗结局。结果两组患者支架植入数量、支架直径和支架长度差异不显著(P>0.05)。治疗前两组左室射血分数(LVEF)、左室舒张末内经(LVEDD)、左室收缩末内径(LVESD)差异不显著(P>0.05);治疗后,观察组LVEF高于对照组,LVEDD、LVESD低于对照组(P<0.01)。观察组患者心血管不良事件发生率低于对照组(P<0.05)。结论为老年急性STEMI患者在病发6 h内给予经皮冠状动脉介入支架植入治疗比病发6~12 h效果好,可改善患者的左室相关功能,提高支架植入效果,减少不良事件的发生率。

Objective To research the significance of percutaneous coronary stent implantation within 6 hours of disease onset in elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Sixty-eight elderly patients with acute STEMI were divided into the control group(thirty-four cases,which were treated with percutaneous coronary stent implantation in 6-12 h after onset)and the observation group(thirty-four cases,which were treated with percutaneous coronary stent implantation within 6 h after onset)according to the timing of onset at the time of admission.The treatment outcomes between the two groups were compared.Results There was no significant difference in the number of stent implantation,the diameter of the stent and the lengh of the stent between the two groups(P>0.05).Before treatment,the left ventricular ejection fraction(LVEF),left ventricular end diastolic meridian(LVEDD),and left ventricular end systolic diameter(LVESD)were not significantly different between the two groups(P>0.05).After treatment,the LVEF of the observation group was higher than that of the control group,while LVEDD and LVESD were lower than those of the control group(P<0.01).The incidence of adverse cardiovascular events in the observation group was lower than that in the control group(P<0.05).Conclusion Percutaneous coronary stent implantation in elderly patients with acute STEMI within 6 h after disease onset is more effective than in 6-12 h after disease onset,which can improve left ventricular related functions,improve the efficacy of stent implantation,and reduce the incidence of adverse events.