急性冠状动脉综合征患者冠状动脉介入治疗前后心脏超声特征变化及预后预测价值

Changes in cardiac ultrasound characteristics and prognostic value in patients with acute coronary syndrome before and after coronary intervention therapy

目的探讨急性冠状动脉综合征(ACS)患者冠状动脉介入治疗前后心脏超声特征变化及预后预测价值。方法选取我院2021年11月至2023年5月收治的150例ACS患者作为研究对象,所有患者均采取经皮冠状动脉介入术治疗,对所有患者进行1年门诊复查随访,分析其治疗情况及随访结果,并对比治疗前后患者心脏超声参数变化。随后将围手术期发生不良事件及1年内发生心血管不良事件的25例患者分为预后不良组,其余125例为预后良好组,对比其临床相关资料及心脏超声参数,以预后情况作为因变量,纳入Logistic回归模型,分析ACS患者的预后独立影响因素。结果150例急性冠状动脉综合征患者围手术期均无死亡病例发生,围术期不良事件发生率为4.7%(7/150),1年内心血管不良事件发生率为12.0%(18/150);治疗后患者心脏指数(CI)、左室射血分数(LVEF)高于治疗前,左心室舒张末期内径(LVEDD)及左心室收缩末期内径(LVESD)低于治疗前(P<0.05);预后良好组与预后不良组性别、体质指数(BMI)、合并基础疾病、饮酒史、LVESD、LVEDD对比差异无统计学意义(P>0.05),预后良好组与预后不良组年龄、美国纽约心脏协会(NYHA)心功能分级、吸烟史、溶栓实验血流分级(TIMI)、CI、LVEF对比差异有统计学意义(P<0.05);年龄、NYHA心功能分级、TIMI、CI、LVEF是影响急性冠状动脉综合征介入治疗预后的独立危险因素(P<0.05)。结论ACS患者冠状动脉介入治疗前后相关心脏超声参数可出现显著变化,通过动态监测心脏超声参数可对急性冠状动脉综合征的预后进行评估,且可借助心脏超声的便捷性、无创性进行早期预测患者预后水平,从而为制定综合性临床干预措施提供参考。

Objective To explore the changes in cardiac ultrasound characteristics and prognostic value of coronary intervention in patients with acute coronary syndrome.Methods One hundred and fifty acute coronary syndrome(ACS)patients admitted to our hospital from November 2021 to May 2023 were selected as study participants.All patients underwent percutaneous coronary intervention(PCI)and a one-year outpatient follow-up was performed to analyze the treatment status and follow-up results.Changes in cardiac ultrasound parameters before and after treatment were compared.Subsequently,25 patients with adverse reactions during the perioperative period and cardiovascular events within a year were classified into a poor prognosis group,while the remaining 125 patients belonged to a good prognosis group.Clinical data and cardiac ultrasound parameters were compared and the prognosis used as a dependent variable and included in the Logistic regression model.The prognosis of ACS patients was an independent influencing factor.Results Of 150 patients with acute coronary syndrome,there were no deaths during the perioperative period.The incidence of perioperative adverse reactions was 4.7%(7/150),and the incidence of cardiovascular adverse reactions was 12.0%(18/150)for one year.After treatment,the patients′cardiac index(CI)and left ventricular ejection fraction(LVEF)were higher than those before treatment,while left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVESD)were lower than those before treatment(P<0.05).There was no significant difference in gender,body mass index(BMI),comorbidities,history of alcohol consumption,LVESD and LVEDD between the group with good prognosis and the group with poor prognosis(P>0.05).However,there were significant differences in age,NYHA heart function classification,smoking history,thrombolysis thrombolysis test blood flow grading(TIMI),CI and LVEF between the group with good prognosis and the group with poor prognosis(P<0.05).Age,NYHA heart function levels,TIMI,CI and LVEF are independent risk factors that influence the prognosis of interventional treatment of acute coronary syndrome(P<0.05).Conclusion There can be significant changes in the relevant cardiac ultrasound parameters of patients with acute coronary syndrome before and after coronary intervention treatment.Dynamic monitoring of cardiac ultrasound parameters can evaluate the prognosis of acute coronary syndrome,and the convenience and non-invasive nature of cardiac ultrasound can be used for early prediction of patient prognosis,providing reference for the development of comprehensive clinical intervention measures.