院前延迟对急性前壁心肌梗死急诊介入治疗患者心功能的影响

Effect of pre⁃hospital delay on cardiac function in patients with acute anterior wall myocardial infarction treated by emergency interventional therapy

目的本研究旨在探讨院前延迟对急性前壁心肌梗死急诊介入治疗患者心功能影响。方法连续收集2018年6月至2019年3月于我院行急诊介入治疗的急性前壁心肌梗死患者57例,根据院前延迟是否大于6 h分为长延迟组及短延迟组。所有患者均收集术后次日及1周的心脏功能指标及左室整体平均应变率(global longitudinal strain⁃average,GLS⁃AVG),术后6个月复查心脏功能指标。结果术后次日左室舒张末内径(left ventricular end diastolic diameter,LVEDD)、左室舒张末容积指数(left ventricular end⁃diastolic volume index,LVEDVI)、左室收缩末容积指数(left ventricular end⁃systolic volume index,LVES⁃VI)差异无统计学意义(P>0.05)。术后次日左室射血分数(left ventricular ejection fraction,LVEF),差异有统计学意义(P=0.02)。术后1周LVEDD两组无明显统计学差异,LVEDVI、LVESVI在短时程组低于长时程组,LVEF高于长时程组(P<0.05)。GLS⁃AVG差异也有统计学意义(P=0.046)。6个月随访过程中仍可见到组间差异(P<0.05)。结论减少院前延搁时间,尽早开通血管能够改善急性前壁心肌梗死患者1周内及6个月的左室收缩功能。

Objective To investigate the effect of pre⁃hospital delay on cardiac function after primary intervention for acute anterior wall myocardial infarction.Methods Fifty⁃seven patients with acute anterior wall myocardial infarction who received primary interventions in our hospital from June 2018 to March 2019 were divided into a long⁃delayed group and a short⁃delayed group according to the pre⁃hospital time.The two groups were compared in terms of cardiac function and global Longitudinal Strain⁃average GLS⁃AVG on the second day and 1 week after the intervention as well as GLS⁃AVG 6 months after intervention.Results There were no significant differences in LVEDD,LVEDVI and LVESVI on the second day between the two groups(P>0.05).LVEF on the second day was significantly different as well(P=0.02).One week after the operation,there was no significant difference in LVEDD,but LVEDVI and LVESVI were significantly lower in the short⁃delayed group than in the long⁃delayed group,and LVEF was significantly higher than in the long⁃delayed group(P<0.05).There was a statistically difference between the two groups(P=0.046)in GLS⁃AVG.During the 6⁃month follow⁃up,there was still significant difference in the cardiac function index between them(P<0.05).Conclusion Reducing the prehospital delay and revascularization as soon as possible can improve the left ventricular systolic function in patients with acute anterior wall myocardial infarction within 1 week and 6 months.