增强型体外反搏联合瑞舒伐他汀对行PCI术治疗的急性心肌梗死患者预后的影响

Effect of Enhanced External Counterpulsation Combined with Rosuvastatin on Prognosis of Patients with Acute Myocardial Infarction Undergoing PCI

【目的】探讨增强型体外反搏联合瑞舒伐他汀对行经皮冠状动脉介入术(PCI)治疗的急性心肌梗死(AMI)患者预后的影响。【方法】前瞻性选取2018年4月至2020年6月本院收治的116例行PCI术治疗的AMI患者,采用随机数表法将其分为观察组和对照组,每组各58例。对照组PCI术后予以瑞舒伐他汀,观察组在对照组的基础上予以增强型体外反搏治疗,均治疗1个月。比较两组疗效与术前、术后1个月心功能指标[左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)]、血液流变学指标(全血高切黏度、全血低切黏度、红细胞沉降率、纤维蛋白原)、血清血管内皮功能指标[一氧化氮(NO)、内皮素-1(ET-1)、血管性假血友病因子(vWF)]水平。并记录两组术后1个月主要不良心血管事件(MACE)发生情况。【结果】观察组临床总有效率为91.38%(53/58),高于对照组的75.86%(44/58),差异有统计学意义(χ^(2)=5.098,P=0.024<0.05)。术后1个月,两组患者LVEF水平高于术前,且观察组高于对照组,LVEDV、LVESV水平较术前降低,且观察组低于对照组(P<0.05);两组患者全血高切黏度、全血低切黏度、红细胞沉降率、纤维蛋白原较术前降低,且观察组低于对照组(P<0.05);两组患者血清NO水平高于术前,且观察组高于对照组,ET-1、vWF水平低于较术前,且观察组低于对照组(P<0.05);观察组患者MACE发生率为6.90%(4/58),低于对照组的22.41%(13/58),差异有统计学意义(χ^(2)=5.583,P=0.018<0.05)。【结论】增强型体外反搏联合瑞舒伐他汀应用于AMI行PCI患者效果显著,较好地改善患者心功能,降低术后MACE发生风险,值得临床借鉴。

【Objective】To investigate the effect of enhanced external counterpulsation combined with rosuvastatin on the prognosis of patients with acute myocardial infarction(AMI)undergoing percutaneous coronary intervention(PCI).【Methods】From April 2018 to June 2020,116 AMI patients who underwent PCI in our hospital were prospectively selected and randomly divided into observation group and control group,58 cases in each group.The control group was treated with rosuvastatin after PCI,and the observation group was treated with enhanced external counterpulsation on the basis of the control group for 1 month.The curative effects of the two groups were compared with the indexes of cardiac function[left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)],hemorheological indexes(whole blood high shear viscosity,whole blood low shear viscosity,erythrocyte sedimentation rate,fibrinogen),serum vascular endothelial function indexes[nitric oxide,Endothelin-1(ET-1)and von Willebrand factor(vWF)]before and 1 month after operation were measured.The incidence of major adverse cardiovascular events(MACE)1 month after operation was recorded.【Results】The total effective rate of observation group was 91.38%(53/58),which was higher than that of the control group[75.86%(44/58],and the difference was statistically significant(χ^(2)=5.098,P=0.024<0.05).The LVEF level of the two groups was higher than that of the control group one month after operation,and the LVEDV and LVESV levels in the observation group were lower than that of the control group(P<0.05);The whole blood viscosity,whole blood low shear viscosity,erythrocyte sedimentation rate and fibrinogen were lower in the two groups than that in the control group(P<0.05);The serum NO level of the two groups was higher than that of the control group,ET-1 and vWF were lower than that of the control group(P<0.05);The incidence of mace in the observation group was 6.90%(4/58),which was lower than that of the control group(22.41%(13/58),and the difference was statistically significant(χ^(2)=5.583,P=0.018<0.05).【Conclusion】Enhanced external counterpulsation combined with rosuvastatin has significant effect in patients after AMI PCI,which can improve the cardiac function and reduce the risk of mace.