脉压与急性ST段抬高型心肌梗死患者经皮冠状动脉介入术近期疗效的关系

发布时间：2018-04-09 23:17

  本文选题：急性ST段抬高型心肌梗死　切入点：脉压　出处：《中华高血压杂志》2016年05期

【摘要】：目的评价脉压与急性ST段抬高型心肌梗死(ASTEMI)患者行经皮冠状动脉介入术(PCI)近期疗效的关系。方法回顾性分析2011年1月至2015年6月ASTEMI行PCI治疗的患者389例,根据脉压分为A组:脉压≤20mm Hg,n=122;B组:脉压20~60mm Hg,n=138;C组:脉压60mm Hg,n=129。观察不同脉压组患者冠状动脉病变严重程度;PCI术前、术后罪犯血管心肌梗死溶栓试验(TIMI)的血流情况,恶性心律失常的发生情况;观察血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTn-I)、血浆氨基末端脑钠尿肽前体(NT-proBNP)峰值情况;对比术后1周6min步行距离;对比术后1周死亡情况;对比PCI术后1周与术前脉压的变化。结果冠状动脉病变累及血管数与累及部位由轻及重依次为B组、C组、A组(均P0.05);3组罪犯血管PCI术前血流情况差异有统计学意义,B组优于C组,更优于A组(均P0.05),PCI术后差异无统计学意义(均P0.05)。术中、术后恶性心律失常的发生由少到多依次为B组、C组、A组,3组间差异有统计学意义(P0.05)。PCI术后CK-MB、cTn-I、NT-proBNP峰值3组间对比均表现为B组C组A组[CK-MB:(57.3±26.4)比(89.4±39.6)比(112.5±48.2)U/L,P0.05;cTn-I:(11.8±5.2)比(15.5±6.4)比(35.0±16.9)μg/L,P0.05;NT-proBNP:(1027.6±629.7)比(2301.1±712.5)比(3239.3±873.6)ng/L,P0.05]。6 min步行距离B组优于C组,更优于A组[(510.7±97.9)比(451.2±92.6)比(378.4±85.6)m,P0.05]。全因死亡、心源性死亡发生率表现为A组C组B组,3组间差异有统计学意义(均P0.05)。心源性休克是A组最重要的死亡原因,但3组间心源性死亡病因发生情况无统计学意义(均P0.05)。PCI术后A组脉压取得明显有益的改善。结论脉压对ASTEMI患者PCI近期预后有一定的预测作用。
[Abstract]:Objective to evaluate the pulse pressure and acute ST elevation myocardial infarction (ASTEMI) undergoing percutaneous coronary intervention (PCI) the relationship between efficacy. Methods: a retrospective analysis of 389 cases from January 2011 to June 2015 ASTEMI PCI patients were divided into A group, according to the pulse pressure pulse pressure less than 20mm Hg, n=122; group B: pulse pressure 20~60mm Hg, n=138; group C: 60mm Hg n=129. to observe the effects of different pulse pressure, pulse pressure in patients with the severity of coronary artery lesions; PCI before surgery, the culprit artery thrombolysis in myocardial infarction (TIMI) postoperative blood flow, arrhythmia; observation of serum creatine kinase isoenzyme (CK-MB), cardiac troponin (I cTn-I), plasma N-terminal pro brain natriuretic peptide (NT-proBNP) peak; contrast after 1 weeks 6min walking distance; contrast died 1 weeks after surgery; 1 weeks before operation and change of pulse pressure after PCI. Comparing the results of coronary vascular lesions involving the number and tired 鍙婇儴浣嶇敱杞诲強閲嶄緷娆′负B缁，

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