阿托伐联合诺欣妥治疗急诊PCI术后急性心肌梗死患者的疗效观察及其对心功能的影响

Effect of atorval combined with nouxital in the treatment of acute myocardial infarction after emergency PCI and its influence on cardiac function

目的探究阿托伐联合诺欣妥治疗急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后急性心肌梗死(acute myocardial infarction,AMI)患者的疗效观察及其对心功能的影响。方法回顾性分析海安市人民医院2019年2月至2022年1月急诊收治的AMI患者病例资料,将符合标准的139例纳入研究。按照其实际治疗情况,分为阿托伐组(87例)和联合组(52例)。其中阿伐托组在常规治疗方案基础上给予阿伐托治疗,联合组在阿托伐组基础上再给予诺欣妥治疗。比较两组患者治疗1个月后临床疗效、心功能变化、血液流变指标变化和并发症情况。结果治疗1个月后,阿伐托组总有效率为78.16%,明显低于联合组的94.23%(P<0.001)。治疗前,两组患者左心室射血分数(left ventricular ejection fraction,LVEF)、室间隔厚度(interventricular septal thickness,IVST)、左心室舒张末期内径(left ventricular end diastolic dimension,LVEDD)无明显差异(均P>0.05)。治疗1个月后,两组LVEF水平均明显上升,IVST和LVEDD水平均明显下降,其中联合组上述三指标变化程度均较阿伐托组更为明显(均P<0.001)。治疗前,两组患者全血低切黏度(whole blood low shear viscosity,WLV)、全血高切黏度(whole blood high shear viscosity,WHV)、D-二聚体(D-Dimer,D-D)和纤维蛋白原(fibrinogen,FIB)水平均无明显差异(均P>0.05)。治疗1个月后,两组患者上述四指标水平均明显下降,其中联合组指标变化程度均较阿伐托组更为明显(均P<0.001)。两组患者手术后均存在梗死再发、心源性休克、心力衰竭、严重心率失常并发症情况,阿伐托组急诊PCI术后并发症总发生率位31.04%,高于联合组的17.32%(P=0.023)。结论阿托伐联合诺欣妥治疗急诊PCI术后AMI患者能够提升临床治疗效果,改善心功能和血液流变指标,同时降低术后并发症发生率。

Objective To investigate the effect of atorval combined with Noxital in the treatment of acute myocardial infarction(AMI)after emergency percutaneous coronary intervention(PCI)and its influence on cardiac function.Methods The data of AMI patients admitted in our hospital from February 2019 to January 2022 were analyzed retrospectively,and 139 cases meeting the criteria were included in the study.According to the actual treatment,they were divided into atorval group(87 cases)and combined group(52 cases).The Avato group was given Avato treatment on the basis of conventional treatment scheme,and the combined group was given Noxital on the basis of Avato.The clinical efficacy,changes of cardiac function,changes of hemorheology,and complications of the two groups were compared after 1 month of treatment.Results After one month of treatment,the total effective rate in the Avatar group was 78.16%,which was significantly lower than that in the combined group(94.23%,P<0.001).Before treatment,there was no difference in left ventricular ejection fraction(LVEF),interventricular septal thickness(IVST),and left ventricular end diastolic dimension(LVEDD)between the two groups(all P>0.05).After one month of treatment,LVEF level in both groups increased significantly,and both IVST and LVEDD decreased significantly.The changes of the above three indicators in the combined group were more significant than those in the Avatar group(all P<0.001).Before treatment,there was no difference in the levels of whole blood low shear viscosity(WLV),whole blood high shear viscosity(WHV),fibrinogen(FIB),and D-Dimer(D-D)between the two groups(all P>0.05).After one month of treatment,the levels of the above four indicators in the two groups decreased significantly,and the changes of the indicators in the combined group were more significant than those in the Avatar group(P<0.001).Both groups had complications such as recurrent infarction,cardiogenic shock,heart failure,and severe arrhythmia after operation.The total incidence of complications after emergency PCI in the Avato group was 31.04%,which was significantly higher than that in the combined group(17.32%,P=0.023).Conclusion Atorval combined with Noxital can improve the clinical therapeutic effect,cardiac function,and hemorheology,and reduce the incidence of postoperative complications in patients with AMI after emergency PCI,which is worthy of clinical promotion.