经桡动脉、股动脉PCI治疗对急性心肌梗死患者心功能、心室重构及并发症的影响

Effects of radial artery and femoral artery percutaneous coronary stenting on cardiac function, ventricular remodeling, and complications in patients with acute myocardial infarction

目的 探究经桡动脉与经股动脉经皮冠脉内支架置入术(PCI)治疗对急性心肌梗死患者心功能、心室重构及并发症的影响。方法 回顾性分析2019年1月至2021年1月于延安大学咸阳医院治疗的109例急性心肌梗死患者的临床资料,根据治疗方法不同将其分为对照组(54例,经股动脉冠脉介入)和观察组(55例,经桡动脉冠脉介入)。比较两组患者经冠脉介入治疗后1周和6个月的舒张期末室间隔厚度(VST)、左室后壁厚度(LVPWT)和治疗前、治疗6个月的左室舒张末期内径(LVDD)、左室收缩末期内径(LVDS)、左室射血分数(LVEF)、短轴收缩率(FS)以及治疗后并发症发生情况。结果 两组患者治疗后1周和6个月的IVST、LVPWT比较差异均无统计学意义(P>0.05);治疗后6个月,两组患者的LVDD、LVDS比较差异均无统计学意义(P>0.05),但观察组患者治疗后的6个月的LVEF、FS分别为(49.23±6.51)%、(31.24±4.26)%,明显高于对照组的(46.13±6.25)%、(25.13±5.17)%,差异均有统计学意义(P<0.05);治疗后,观察组患者的并发症总发生率为7.72%,明显低于对照组的24.07%,差异有统计学意义(P<0.05)。结论 经桡动脉经冠脉介入治疗急性心肌梗死能促进左心室重构,改善心功能,可有效降低并发症发生率。

Objective To explore the effects of transradial and transfemoral percutaneous coronary stenting on cardiac function, ventricular remodeling, and complications in patients with acute myocardial infarction. Methods The clinical data of 109 patients with acute myocardial infarction treated in Xianyang Hospital of Yan’an University from January 2019 to January 2021 were retrospectively analyzed, and they were divided into a control group(54 cases, transfemoral percutaneous coronary stenting) and an observation group(55 cases, transradial percutaneous coronary stenting). The end-diastolic septum thickness(VST), left ventricular posterior wall thickness(LVPWT), and left ventricular end-diastolic diameter(LVDD) before PCI and at 6 months after PCI were compared between the two groups, as well as left ventricular end-systolic diameter(LVDS), left ventricular ejection fraction(LVEF), short-axis systolic rate(FS), and complications after treatment. Results There was no significant difference in IVST and LVPWT between the two groups at 1 week and 6 months after treatment(P>0.05). At 6 months after treatment, there was no significant difference in LVDD and LVDS between the two groups(P>0.05);the LVEF and FS in the observation group were(49.23±6.51)%and(31.24±4.26)%, respectively, which were significantly higher than(46.13±6.25)% and(25.13±5.17)% in the control group(P<0.05). After treatment, the incidence of complications in the observation group was 7.72%, which was significantly lower than 24.07% in the control group(P<0.05). Conclusion Transradial percutaneous coronary stenting in the treatment of acute myocardial infarction can promote left ventricular remodeling, improve cardiac function, and effectively reduce the incidence of complications.