不同时间窗介入治疗对急性心肌梗死患者效果及睡眠质量的影响分析

Influence Analysis of Interventional Therapy in Different Time Windows on the Effect and Sleep Quality of Patients with Acute Myocardial Infarction

目的:探讨不同时间窗介入治疗在急性心肌梗死患者中的效果及对睡眠质量的影响。方法:回顾性分析2021年10月-2022年9月于普宁华侨医院进行治疗的80例老年急性心肌梗死患者的临床资料,依据其发病后到介入治疗所用时间差异分为对照组和研究组,各40例。对照组发病到介入治疗时间为3~12 h,研究组发病到介入治疗时间为3 h内。对两组的睡眠质量、治疗总有效率、不良心血管事件发生率及治疗前后的心肌酶[脑钠肽(BNP)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)]、心功能[左室射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)]相关指标变化情况进行观察。结果:研究组总有效率(92.50%)比对照组(72.50%)高(P<0.05);研究组治疗后日间功能、睡眠质量、催眠药物、入睡时间、睡眠障碍、睡眠时间、睡眠效率评分均比对照组低(P<0.05);研究组不良心血管事件发生率(7.50%)比对照组(35.00%)低(P<0.05);研究组治疗后LVEF高于对照组,LVESV、LVEDV、BNP、CK-MB、cTnT均低于对照组(P<0.05)。结论:急性心肌梗死患者发病到介入治疗时间控制在3 h内更好,不仅可以提高治疗效果,降低不良心血管事件发生率,还可以改善患者的心功能和睡眠质量,值得推广应用。

Objective: To investigate the effects of different time windows of interventional therapy on patients with acute myocardial infarction and the influence on sleep quality. Method: The clinical data of 80elderly patients with acute myocardial infarction treated in Puning Overseas Chinese Hospital from October 2021to September 2022 were retrospectively analyzed. According to the time difference from onset to interventional therapy, they were divided into control group and research group, with 40 cases in each group. The time from onset to interventional therapy in the control group was 3-12 h, and the time from onset to interventional therapy in the research group was within 3 h. Sleep quality, total effective rate of treatment, incidence of adverse cardiovascular events, and myocardial enzymes [brain natriuretic peptide(BNP), creatine kinase isoenzymes(CK-MB), cardiac troponin T(cTnT)], cardiac function [left ventricular ejection fraction(LVEF), left ventricular end systolic volume(LVESV), left ventricular end diastolic volume(LVEDV)] before and after treatment in the two groups were observed.Result: The total effective rate of the research group(92.50%) was higher than that of the control group(72.50%)(P<0.05). The scores of daytime function, sleep quality, hypnotic drugs, time to fall asleep, sleep disorder, sleep duration and sleep efficiency in the research group were lower than those in the control group(P<0.05). The total incidence of adverse cardiovascular events in the research group(7.50%) was lower than that in the control group(35.00%)(P<0.05). After treatment, LVEF in the research group was higher than that in the control group, and LVESV, LVEDV, BNP, CK-MB and cTnT were lower than those in the control group(P<0.05). Conclusion: It is better to control the time from the onset of acute myocardial infarction to interventional therapy within 3 hours, which can not only improve the therapeutic effect, reduce the incidence of adverse cardiovascular events, but also improve the heart function and sleep quality of patients, and is worthy of popularization and application.