经皮冠脉介入手术时机对急性心肌梗死后左室重构及心功能的影响

Effect of timing of percutaneous coronary Intervention on left ventricular Remodeling and cardiac Function after acute myocardial Infarction

目的分析经皮冠脉介入手术时机对急性心肌梗死后左室重构及心功能的影响。方法将2018年8月至2019年8月安阳市人民医院收治的86例急性心肌梗死患者作为研究对象,将其以随机原则分为对照组和观察组,各43例,对照组患者行择期经皮冠脉介入手术,观察组患者行急诊经皮冠脉介入手术。对比分析两组患者的左室收缩末直径(LVSEd)、左室射血分数(LVEF)、左房内径(LAd)、以及左室舒张末径(LVDEd)等指标。结果观察组患者的左室收缩末直径、左室射血分数、左房内径、左室舒张末径明显低于对照组;观察组患者心力衰竭发生率,明显低于对照组,差异显著(P<0.05);观察组患者治疗有效率,明显高于对照组,差异显著(P<0.05)。结论急诊经皮冠脉介入手术能够有效抑制交感激活和RAAS系统,改善急性心肌梗死患者左室重构和心功能,降低心力衰竭发生率。

Objective To analyze the effect of percutaneous coronary intervention(PCI)on left ventricular remodeling and cardiac function after acute myocardial infarction(AMI).Methods A total of 86 patients with acute myocardial infarction admitted to Anyang People’s Hospital from August 2018 to August 2019 were randomly divided into control group(43 cases)and observation group(43 cases),patients in the control group underwent elective percutaneous coronary intervention,while patients in the observation group underwent emergency percutaneous coronary intervention.The indexes of left ventricular endsystolic diameter,left ventricular end-diastolic diameter,left ventricular ejection fraction and left atrial diameter were analyzed.Results The end systolic diameter(LVSED),left ventricular ejection fraction(LVEF),left atrial diameter(LAD)and left ventricular end diastolic diameter(LVDED)in the observation group were significantly lower than those in the control group,and the incidence of heart failure in the observation group was 6.98%,significantly lower than that in the control group(P<0.05),the effective rate of the observation group was 95.35%,which was significantly higher than that of the control group(P<0.05).Conclusion The timing of percutaneous coronary intervention,in contrast,emergency percutaneous coronary intervention can effectively inhibit sympathetic activation and RAAS system,improve left ventricular remodeling and cardiac function in patients with acute myocardial infarction,reduce the incidence of heart failure.