易化经皮冠状动脉介入治疗早期阻抑急性心肌梗死左室重构的效应

发布时间：2018-08-22 17:36

【摘要】：目的探讨易化经皮冠状动脉介入治疗(PCI)早期阻抑急性心肌梗死(AMI)左室重构的效应。方法选择AMI患者122例,随机分为两组,观察组应用易化PCI,对照组应用直接PCI法进行治疗,同时另选择61例一般资料无显著差异,仅行溶栓治疗的患者作为溶栓组。三组患者于发病后1、28 w进行平衡法核素心室造影(ERNA)检查并对左室收缩功能与反常容积指数进行比较,并于28 w内随访患者发生恶性心脏事件(MACE)的发生率。结果观察组和对照组分别与溶栓组相比,肌酸激酶同工酶(CK-MB)的水平均明显较低,PCI前梗死相关血管(IRA)的开通率,对照组显著低于观察组和溶栓组,术后罪犯血管的血流分级,TIMI-3级的概率,对照组远低于观察组(P0.05),左室重构的比较:观察组的反常矛盾消失情况明显优于溶栓组(P0.05),观察组与对照组相较于溶栓组来说,梗死后心绞痛的发病率、再梗死率、死亡率均低于溶栓组(P0.05),脏器及颅内出血的比较,三组无显著差异(P0.05)。结论易化PCI治疗,可对梗死相关动脉达到早期开通,充分解除梗死的效果,还可早期对左室重构进行阻抑,值得临床推广应用。
[Abstract]:Objective to investigate the effect of facilitated percutaneous coronary intervention (PCI) on left ventricular remodeling in patients with acute myocardial infarction (AMI) after early (PCI). Methods 122 patients with AMI were randomly divided into two groups. The observation group was treated with PCI, the control group was treated with direct PCI, and 61 patients with thrombolytic therapy were selected as thrombolytic group. The left ventricular systolic function and abnormal volume index were examined by balanced radionuclide ventriculography (ERNA) at 1 and 28 weeks after onset, and the incidence of malignant cardiac events (MACE) was followed up within 28 weeks. Results compared with thrombolytic group, the level of creatine kinase isoenzyme (CK-MB) in observation group and control group was significantly lower than that in observation group and thrombolytic group, and the opening rate of infarct-related vascular (IRA) in control group was significantly lower than that in observation group and thrombolytic group. The probability of blood flow grading and TIMI-3 grade was much lower in the control group than in the observation group (P0.05). The comparison of left ventricular remodeling: the abnormal contradiction disappeared in the observation group was significantly better than that in the thrombolytic group (P0.05), and the observation group and the control group were compared with the thrombolytic group. The incidence rate and mortality of angina pectoris after infarction were lower than that of thrombolytic group (P0.05). There was no significant difference among the three groups (P0.05). Conclusion the facilitation of PCI therapy can open the infarct-related artery early, relieve the infarct fully, and inhibit the left ventricular remodeling in the early stage, which is worthy of clinical application.
【作者单位】：武汉亚洲心脏病医院;
【分类号】：R542.22

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