高压氧在老年冠状动脉支架术后患者中的应用效果

Application effect of hyperbaric oxygen on aged patients after percutaneous coronary intervention

目的:探讨高压氧在老年冠状动脉支架术后患者的应用效果。方法:选择135例行PCI治疗的老年冠心病患者,其中61例PCI术后行高压氧治疗2周(高压氧组),74例未行高压氧治疗(无高压氧组)。观察两组治疗前后西雅图心绞痛问卷(SAQ)评分、血脂指标[脂蛋白磷脂酶A2(Lp-PLA2),载脂蛋白A-1(ApoA1),载脂蛋白B(ApoB)]、心肌损伤指标[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、N末端B型利钠肽原(NT-proBNP)]的变化和差异;比较随访6个月内主要心脏不良事件(MACE)、支架内再狭窄(ISR)发生率的差异。结果:与无高压氧组比较,高压氧组治疗后SAQ各维度评分及总分[(71.59±5.66)分比(78.67±6.22)分]、ApoA1水平均显著增加,Lp-PLA2、ApoB、CK-MB、cTnI、NT-proBNP水平及随访期间MACE(29.73%比13.11%)发生率显著降低(P<0.05或<0.01)。两组ISR发生率无显著性差异(P=0.933)。结论:高压氧可改善老年冠心病患者冠状动脉支架术后临床症状,高血脂状态和心功能,降低心血管事件发生风险。

Objective:To explore application effect of hyperbaric oxygen(HBO) on aged patients after percutaneous coronary intervention(PCI).Methods:A total of 135 aged patients with coronary heart disease undergoing PCI were selected,including 61 patients who received HBO therapy for two weeks after PCI(HBO group),and 74 patients who didn't receive HBO therapy(no HBO group).Seattle Angina Questionnaire(SAQ) score,lipid indexes [lipoprotein phospholipase A2(Lp-PLA2),apolipoprotein A-1(ApoA1),ApoB],myocardial injury indexes [creatine kinase isoenzyme MB(CK-MB),cardiac troponin I(cTnI),N-terminal pro-B-type natriuretic peptide(NT-proBNP)]were observed and compared between two groups before and after treatment;incidence rates of major adverse cardiac events(MACE) and in-stent restenosis(ISR) within six-month follow-up were compared between two groups before and after treatment.Results:Compared with no HBO group after treatment,there were significant rise in each dimension score and total score of SAQ [(71.59±5.66) scores vs.(78.67±6.22) scores],and ApoA1 level,and significant reductions in levels of Lp-PLA2,ApoB,CK-MB,cTnI,NT-proBNP and incidence rate of MACE during follow-up(29.73%vs.13.11%) in HBO group,P0.05 or 0.01.There was no significant difference in incidence rate of ISR between two groups,P=0.933.Conclusion:Hyperbaric oxygen can improve clinical symptoms,hyperlipidemia and cardiac function,and reduce risk of cardiovascular events in aged patients with coronary heart disease after PCI.