早期溶栓治疗对高血压合并心肌梗死患者左室心脏结构及功能的影响

Effect of early thrombolytic therapy on left ventricular structure and function in patients with hypertension and myocardial infarction

目的探讨早期溶栓治疗对高血压合并心肌梗死患者左室心脏结构及功能的影响。方法将我院2019年1月至2020年5月收治的100例高血压合并心肌梗死患者按随机数字表法分为对照组与试验组。对照组采用延期溶栓治疗,试验组采用早期溶栓治疗,比较2组治疗前后左室结构、功能变化(NT-proBNP)水平变化以及治疗后心脏不良事件发生率。结果入院12 h、24 h、72h时,试验组NT-proBNP水平均低于对照组(P<0.05)。2组治疗后左室质量指数(LVMI)、左室收缩末期容积指数(LVEDV)、左室舒张末期容积指数(LVESV)值均低于治疗前,且试验组低于对照组(P均<0.05)。2组治疗后左室射血分数(LVEF)、二尖瓣口血流E峰与A峰比值(E/A)值高于治疗前,室壁运动记分指数(WMSI)值低于治疗前,且试验组LVEF、E/A值高于对照组,WMSI值低于对照组(P均<0.05)。试验组治疗后心脏不良事件发生率为18%,低于对照组38%(P<0.05)。结论早期溶栓治疗可以有效降低高血压合并心肌梗死患者的NT-proBNP水平,改善患者左室心脏结构和功能,降低心脏不良事件发生率。

Objective To investigate the effect of early thrombolytic therapy on left ventricular structure and function in patients with hypertension and myocardial infarction.Methods One-hundred patients with hypertension and myocardial infarction admitted to our hospital between January 2019 and May 2020 were randomized to the control group and the study group.The control group was treated with postponed thrombolysis and the study group with early thrombolysis.The two groups were compared for changes in left ventricular structure and function,NT-proBNP levels before and after treatment,and incidence of adverse cardiac events after treatment.Results At 12 h,24 h,and 72 h after admission,the NT-proBNP levels were lower in the study group than those in the control group(P<0.05).The values of LVMI,LVEDV and LVESV after treatment were lower than baseline in either group,and were lower in the study group than those in the control group(all P<0.05).After treatment,the LVEF and E/A values were higher and WMSI was lower than baseline in either group;the study group showed higher LVEF and E/A values and lower WMSI compared with the control group(all P<0.05).The incidence of adverse cardiac events after treatment was 18%in the study group,which was lower than that(38%)in the control group(P<0.05).Conclusion Early thrombolytic therapy can effectively lower the level of NT-proBNP in patients with hypertension and myocardial infarction,improve the structure and function of the left ventricle,and reduce the incidence of adverse cardiac events.