重症急性心肌梗死患者在经皮冠状动脉介入治疗围术期行持续肾替代治疗的效果研究

Study on the effect of continuous renal replacement therapy in patients with severe acute myocardial infarction during the perioperative period of percutaneous coronary intervention

目的 分析重症急性心肌梗死患者在经皮冠状动脉介入治疗围术期行持续肾替代治疗的效果。方法 90例急性心肌梗死患者,按照随机数字表法分为参照组及研究组,每组45例。参照组患者采用经皮冠状动脉介入治疗,研究组患者在经皮冠状动脉介入治疗围术期行持续肾替代治疗。比较两组患者治疗前后收缩压、舒张压、心率、肝肾功能指标(总胆红素、谷草转氨酶、谷丙转氨酶、尿素氮、肌酐)。结果 治疗后,研究组收缩压、舒张压、心率水平分别为(112.17±10.46)mm Hg(1 mm Hg=0.133 kPa)、(74.16±13.08)mm Hg、(69.16±2.03)次/min,均低于参照组的(123.36±18.45)mm Hg、(87.13±10.02)mm Hg、(83.22±2.56)次/min,差异具有统计学意义(P<0.05)。治疗后,研究组患者总胆红素、谷草转氨酶、谷丙转氨酶、尿素氮、肌酐水平分别为(18.12±2.46)μmol/L、(33.15±2.03)U/L、(33.14±2.03)U/L、(11.18±2.03)mmol/L、(78.14±6.02)μmol/L,均低于参照组的(22.36±2.45)μmol/L、(43.46±2.21)U/L、(46.48±6.66)U/L、(13.12±2.05)mmol/L、(97.48±12.11)μmol/L,差异具有统计学意义(P<0.05)。结论 重症急性心肌梗死患者在经皮冠状动脉介入治疗围术期行持续肾替代治疗的效果较好,能够改善患者生命体征及肝肾功能指标。

Objective To analyze the effect of continuous renal replacement therapy in patients with severe acute myocardial infarction during the perioperative period of percutaneous coronary intervention. Methods A total of 90 patients with acute myocardial infarction were randomly divided into the reference group and the research group, with 45 patients in each group. Patients in the reference group were treated with percutaneous coronary intervention, while patients in the research group were treated with continuous renal replacement therapy during the perioperative period of percutaneous coronary intervention. Both groups were compared in terms of systolic blood pressure, diastolic blood pressure, heart rate, liver and kidney function indexes(total bilirubin,glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, urea nitrogen, creatinine) before and after treatment. Results After treatment, the systolic blood pressure, diastolic blood pressure, and heart rate levels in the research group were(112.17±10.46) mm Hg(1 mm Hg=0.133 kPa),(74.16±13.08) mm Hg, and(69.16±2.03) beats/min, which were lower than(123.36±18.45) mm Hg,(87.13±10.02) mm Hg, and(83.22±2.56) beats/min in the reference group, and the differences were statistically significant(P<0.05). After treatment,the total bilirubin, glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, urea nitrogen, and creatinine levels of patients in the research group were(18.12±2.46) μmol/L,(33.15±2.03) U/L,(33.14±2.03) U/L,and(11.18±2.03) mmol/L, and(78.14±6.02) μmol/L, which were lower than(22.36±2.45) μmol/L,(43.46±2.21) U/L,(46.48±6.66) U/L,(13.12±2.05) mmol/L, and(97.48±12.11) μmol/L in the reference group, and the differences were statistically significant(P<0.05). Conclusion Continuous renal replacement therapy in patients with severe acute myocardial infarction during the perioperative period of percutaneous coronary intervention is more effective and can improve patients’ vital signs and liver and kidney function indices.