冠心病射血分数中间值心力衰竭患者经皮腔内冠状动脉介入治疗术后效果分析

Clinical Analysis of Coronary Heart Disease Patients with Heart Failure of Mid-range Ejection Fraction after Percutaneous Coronary Intervention

目的 探讨经皮腔内冠状动脉介入术(percutaneous coronary intervention,PCI)治疗冠心病射血分数中间值心力衰竭(heart failure with mid-range ejection fraction,HFmrEF)患者的有效性。方法 将沈阳医学院附属第二医院2019年1月至2020年1月收治的101例冠心病HFmrEF患者,根据其治疗意愿分为PCI治疗组(56例)和单纯药物治疗组(45例)。治疗1年后比较两组患者的N末端脑钠肽前体(N-terminal probrain natriuretic peptide,NT-proBNP)、左室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、6 min步行试验距离等心功能指标,以及出血、非致死性心肌梗死、再发心绞痛行PCI治疗、心衰再住院率以及全因死亡等临床事件。结果 两组患者一般临床资料差异均无统计学意义(P均>0.05)。治疗1年后,与单纯药物治疗组比较,PCI治疗组患者NT-proBNP降低、LVEF升高、LVEDD缩小、6 min步行试验距离增加(P均<0.05);非致死性心肌梗死率、再发心绞痛行PCI治疗率、心力衰竭再住院率、全因病死率均较单纯药物治疗组降低(P均<0.05)。结论 与单纯药物治疗比较,PCI治疗可改善冠心病HFmrEF患者的左心室功能,抑制心室重构,改善患者预后。

Objective To investigate the clinical benefits of percutaneous coronary intervention(PCI)for coronary heart disease patients with heart failure with mid-range ejection fraction.Methods According to the wishes of the patients,a total of 101 CHD patients with HFmrEF in the Second Affiliated Hospital of Shenyang Medical University from January 2019 to January 2020 were classified into two groups,PCI group(56 cases)and medication treatment group(45 cases).The cardiac function indexes including N-terminal pro-brain natriuretic peptide,left ventricular end diastolic diameter,6-minute walking test,and adverse clinical events including bleeding,nonfatal myocardial infarction,PCI for recurrent angina pectoris,rehospitalization ratio of heart failure,and all-cause death,were carefully collected and analyzed at the baseline and after one-year treatment.Results There were no statistical differences in baseline between the two groups(P all>0.05).After one-year treatment,comparing with the medication treatment group,there were significantly lower NT-pro BNP level,significantly higher LVEF ratio,significantly lower LVEDD value,significantly higher6-minute walking test tolerance(P all<0.05).The rate of non fatal myocardial infarction,the rate of recarrent angina pectoris with PCI,the rehospitalization ratio of heart failure,and all-cause death(P all<0.05)in the PCI group have been significantly reduced.Conclusion Compared with medication treatment,PCI significantly shows prognosis benefits profile for CHD patients with HFmrEF,which improves the left ventricular function and reverses ventricular remodeling.Meanwhile it reduces the rate of non-fatal myocardial infarction,recurrent angina pectoris treated with PCI,rehospitalization rate of heart failure,and mortality.