急诊PCI中监测血氧饱和度对急性ST段抬高型心肌梗死的疗效和预后的影响  

Efficacy and Prognosis of Monitoring Pulse Oxygen Saturation During Primary Percutaneous Coronary Intervention with ST-segment Elevation Myocardial Infarction

作　　者：王红雷[1] 董平栓[1] 尚喜燕[1] 邢适颖[1] 李治国[1] 曲红培[1] 

机构地区：[1]河南科技大学第一附属医院,河南洛阳471003

出　　处：《河南科技大学学报（医学版）》2014年第4期247-250,共4页Journal of Henan University of Science & Technology:Medical Science

摘　　要：目的探讨急诊经皮冠状动脉介入治疗(PCI)术中脉搏血氧饱和度(Sp O2)水平与急性ST段抬高型心肌梗死(STEMI)患者临床疗效和预后的关系。方法选择进行急诊PCI术的STEMI患者126例,依据Sp O2水平分为观察组58例(Sp O2<90%)和对照组68例(Sp O2>90%)。观察两组患者冠状动脉血管病变支数,术后4周的左室收缩末期容积(LVESV)、舒张末期容积(LVEDV)和左室射血分数(LVEF);两组患者住院期间及术后1 a时的主要心脏不良事件和6 min步行试验。结果观察组冠状动脉病变支数较对照组高[P<0.05],前降支为梗死相关血管的比例多于对照组(P<0.05);术后4周观察组的LVESV、LVEDV较对照组高,LVEF较对照组低,差异有统计学意义。观察组住院期间及1 a时的主要不良心脏事件较对照组高,1 a时的6 min步行试验的步行距离较对照组短,差异有统计学意义。结论急诊PCI术中脉搏血氧饱和度水平是评价STEMI患者临床疗效和预后的一种可靠指标,有利于指导临床实践。Objective To investigate the relationship between pulse oxygen saturation （SpO2 ） during primary percutaneous coronary intervention（PCI） in patients with ST-segment elevation myocardial infarction （STEMI） and its clinical efficacy and prognostic value. Methods We studied 126 STEMI patients who monitored pulse oxygen saturation continuously during primary PCI. According to the SpO2 , the patients were divided into the observation group（n = 58, SpO2 〈90% ） and the observation group （n = 68, SpO2 〉90% ）, observing the number of the stenotic vessls, left ventricular end-systolic volume （LVESV） , left ventricular end-diastolic volume （LVEDV） and left ventricular ejection fraction （LVEF） 4 weeks after PCI, and also analyzing the major adverse cardiac events （MACE） and six-minute walk test between the hospitalization period and 1 year after PCI. Results There were no significant differences in sex, age, susceptible factors （ eg hypertension, hyperlipidemia, diabetes mellitus, smoking, et al） , hemoglobin level, original heart disease history, door to balloon time and the number of stent implantation between the two groups in the baseline characteristics. The number of the stenotie vessls in the observation group was more than the observation group [ P 〈 0.05 ] ,and the percentage of infarct-related artery in the left anterior descending artery was also higher （P 〈 0.05 ）. The diameters of LVESV, LVEDV were larger, and the LVEF was lower than the control group. The incidence of MACE between the hospitalization period and 1 month after PCI in the observation group was higher,while shorter with the six-minute walk test than the control group. Conclusion The SpO2 during primary PCI with STEMI is a reliable index in evaluating the clinical efficacy and prognostic value, which can guide clinical practice.

关 键 词：血氧饱和度 急性心肌梗死 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]