冠状动脉介入治疗冠心病急性心肌梗死的临床疗效及其对心室重构的影响

Clinical efficacy of coronary intervention in the treatment of coronary heart disease and acute myocardial infarction and its effects on ventricular remodeling

目的探讨冠状动脉介入治疗冠心病急性心肌梗死的临床疗效及其对心室重构的影响。方法选取高州市中医院2017年6月至2019年8月收治的92例冠心病急性心肌梗死患者作为研究对象,结合患者实际情况及手术标准,在不损害患者利益的前提下,考虑患者选择意愿,按照其不同治疗方式分为对照组(n=46,采用静脉溶栓治疗)与观察组(n=46,采用冠状动脉介入治疗)。比较两组治疗前后心功能指标[左心室射血分数(LVEF)、左心室收缩末期容积(LESV)、左心室舒张末期容积(LEDV)]、B型脑钠肽(BNP)的变化情况,同时采用美国国立卫生研究院卒中量表(NIHSS)评价患者治疗前后神经功能缺损程度。结果两组治疗前的LVEF、LESV、LEDV及BNP水平、NIHSS评分比较,差异无统计学意义(P>0.05);治疗7 d后,观察组的LVEF明显高于治疗前和对照组,LESV、LEDV及BNP水平、NIHSS评分均明显低于治疗前和对照组(P<0.05)。结论冠心病急性心肌梗死患者行冠状动脉介入治疗的效果较理想,有利于逆转心室重构,促进心功能尽早恢复,减轻神经功能缺损程度,加快疾病康复进程。

Objective To investigate the clinical efficacy of coronary intervention in the treatment of coronary heart disease and acute myocardial infarction and its effects on ventricular remodeling.Methods A total of 92 patients with coronary heart disease and acute myocardial infarction admitted and treated at Gaozhou Traditional Chinese Medicine Hospital from June 2017 to August 2019 were selected as subjects for the study.Combined with the actual situation of the patients and the surgical standards,the patients were treated according to their choice intention on the premise of not harming the interests of the patients.The patients were divided into the control group(n=46,performed with intravenous thrombolysis)and the observation group(n=46,performed with coronary intervention)according to different therapy methods.The changes in cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LESV),and left ventricular end-diastolic volume(LEDV)]and B-type natriuretic peptide(BNP)before and after treatment were observed and compared between the two groups.Meanwhile,National Institutes of Health Stroke Scale(NIHSS)was adopted to evaluate the degree of neurologic impairment of patients before and after treatment.Results There was no statistically significant difference in the levels of LVEF,LESV,LEDV and BNP and the NIHSS score between the two groups before treatment(P>0.05);after 7 d of treatment,LVEF in the observation group was significantly higher than that before treatment and in the control group,while the levels of LESV,LEDV and BNP and the NIHSS score were significantly lower than those before treatment and in the control group(P<0.05).Conclusion Coronary intervention in patients with coronary heart disease and acute myocardial infarction has a relatively ideal effect,which is beneficial to reverse ventricular remodeling,promote early recovery of cardiac function,reduce the degree of neurologic impairment,and accelerate the process of disease rehabilitation.