早期使用β受体阻滞剂和ACEI对接受冠状动脉介入治疗的STEMI患者近中期预后的影响

Effect of Early Use of Beta Blockers and ACEI on Near-Medium Term Outcomes in Patients with STEMI Undergoing Coronary Intervention

目的探讨早期使用β受体阻滞剂和ACEI对接受冠状动脉介入治疗的ST段抬高型心肌梗死(ST-segment Elevation Myocardial Infarction,STEMI)患者近中期预后的影响。方法选取2018年5月~2021年11月在本院就诊的STEMI82例,采用随机数字表法分组,即对照组、观察组,均41例。两组均予以β受体阻滞剂和血管紧张素转换酶抑制剂(Angiotension Con-verting Enzyme Inhibitor,ACEI)治疗,仅干预时间不同,其中对照组在介入治疗后至出院前时期应用。观察组在确诊后和介入前进行早期治疗。统计两组患者纽约心脏病协会(New York Heart Association,NYHA)分级、心功能、恶性心律失常发生率、再梗死率及死亡率。结果观察组NYHA分级显著优于对照组,观察组Ⅰ级占比75.61%明显高于对照组,Ⅱ级、Ⅲ级及Ⅳ级也均低于对照组,差异具有统计学意义(P<0.05)。干预前,两组LVESV、LVEDD、LVEF比较,差异无统计学意义(P>0.05),干预后,两组LVESV、LVEDD均下降,LVEF上升,组间比较,观察组LVESV、LVEDD低于对照组,LVEF高于对照组,差异具有统计学意义(P<0.05)。观察组恶性心律失常发生率2.44%、再梗死率0及死亡率4.88%均低于对照组,差异具有统计学意义(P<0.05)。结论STEMI患者早期予以β受体阻滞剂和ACEI治疗,可减少恶心心律失常、再梗死及死亡发生率,改善心功能,值得推广。

Objective To investigate the effects of early use of beta-blockers and ACEI on the near-to-medium outcomes of ST-segment Elevation Myocardial Infarction(STEMI)in patients undergoing coronary intervention.Methods A total of 82 STEMI patients admitted to our hospital from May 2018 to November 2021 were selected and divided by random number table,i.e.,control group and observation group,with 41 cases in both.Both groups were treated withβ-blockers and Angiotension Con-verting Enzyme Inhibitor(ACEI).Only the intervention time was different,and the control group was treated from after interventionary therapy to before discharge.The observation group received early treatment after diagnosis and before intervention.New York Heart Association(NYHA)grading,cardiac function,incidence of malignant arrhythmias,reinfarction rate,and mortality were measured in both groups.Results NYHA grade in the observation group was significantly better than that in the control group,the proportion of gradeⅠin the observation group was 75.61%higher than that in the control group,and gradeⅡ,gradeⅢand gradeⅣwere also lower than that in the control group,the difference was statistically significant(P<0.05).Before intervention,LVESV,LVEDD and LVEF of the two groups showed no statistical significance(P>0.05).After intervention,LVESV and LVEDD of the two groups decreased,while LVEF of the two groups increased.Compared between groups,LVESV and LVEDD of the observation group were lower than that of the control group,while LVEF of the observation group was higher than that of the control group.The difference was statistically significant(P<0.05).The incidence of malignant arrhythmia(2.44%),reinfarction(0)and mortality(4.88%)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:Early treatment withβ-blockers and ACEI in STEMI patients can reduce the incidence of nausea,arrhythmia,reinfarction and death,and improve cardiac function,which is worth popularization.