非梗死相关动脉的不同处理方式对STEMI合并多支病变患者血清Nesfatin-1水平及预后的影响

Influence of different treatment manners of non-infarct related artery on Nesfatin-1 level and prognosis in STEMI patients with multivessel coronary disease

目的:探讨非梗死相关动脉(non-IRA)的不同处理方式对ST段抬高型心肌梗死(STEMI)合并多支血管病变(MVD)患者血清摄食抑制因子-1(Nesfatin-1)水平及预后的影响。方法:选择2017年5月至2019年5月于本院治疗的STEMI合并MVD患者作为研究对象,直接经皮冠状动脉介入治疗(PCI)成功开通梗死相关动脉(IRA)后,根据non-IRA不同处理方式,分为同期PCI组与分期PCI组,各100例。收集两组一般资料,记录冠状动脉造影(CAG)、non-IRA分布和狭窄程度以及PCI资料,术后随访12个月,比较两组患者血清Nesfatin-1水平及主要不良心血管事件(MACE)发生率。结果:与分期PCI组比较,同期PCI组血清Nesfatin-1[(0.92±0.29)ng/L比(1.21±0.35)ng/L]水平显著升高,PCI时间[(147.56±48.82)min比(90.55±35.17)min]、造影剂用量[(282.17±72.79)ml比(189.42±61.32)ml]、住院时间[(9.41±1.54)d比(5.62±1.12)d]及MACE发生率(56.00%比41.00%)均显著减少(P<0.05或<0.01)。结论:STEMI合并MVD患者同期PCI处理non-IRA能够显著缩短PCI时间及住院时间,减少造影剂用量,降低术后MACE发生率,提高血清Nesfatin-1水平,且未增加围术期并发症的发生。

Objective:To explore influence of different treatment manners of non-infarct related artery(non-IRA)on serum Nesfatin-1 level and prognosis in patients with ST elevation myocardial infarction(STEMI)complicated multivessel coronary disease(MVD).Methods:STEMI+MVD patients treated in our hospital from May 2017 to May 2019 were selected.After IRA were opened by direct percutaneous coronary intervention(PCI),according to different treatment manners of non-IRA,patients were divided into simultaneous PCI group(n=100)and staged PCI group(n=100).General data were collected in two groups,data of coronary angiography(CAG),non-IRA distribution and stenotic degree,and PCI were recorded.Patients were followed up for 12 months after PCI,serum Nesfatin-1 level and incidence rate of major adverse cardiovascular events(MACE)were compared between two groups.Results:Compared with staged PCI group,there was significant rise in serum Nesfatin-1 level[(0.92±0.29)ng/L vs.(1.21±0.35)ng/L],and significant reductions in PCI time[(147.56±48.82)min vs.(90.55±35.17)min],contrast agent dosage[(282.17±72.79)ml vs.(189.42±61.32)ml],in-hospital stay[(9.41±1.54)d vs.(5.62±1.12)d]and incidence rate of MACE(56.00%vs.41.00%)in simultaneous PCI group,P<0.05 or<0.01.Conclusion:Non-IRA treated by simultaneous PCI can significantly shorten PCI time and in-hospital stay,reduce contrast agent dosage and postoperative incidence rate of MACE,and increase serum Nesfatin-1 level without increasing incidence of perioperative complications in STEMI+MVD patients.