急诊行为干预对急性冠状动脉综合征患者的影响  

Effects of emergency behavior interventions in acute coronary syndrome patients

作　　者：娄国平[1] 田彩霞[2] 李显东[1] 张昭勇[1] 

机构地区：[1]湖北医药学院附属太和医院检验部,湖北十堰442000 [2]湖北医药学院人民医院检验科,湖北十堰442000

出　　处：《检验医学与临床》2015年第7期895-896,899,共3页Laboratory Medicine and Clinic

基　　金：湖北省教育厅科研项目(B2013123)

摘　　要：目的探讨急性冠状动脉综合征(ACS)患者介入治疗术后急诊行为干预的效果。方法将220例ACS患者随机分为观察组与对照组,每组各110例。所有患者均给予介入治疗与西医标准化药物治疗。对照组术后给予常规卧床休息与被动活动。观察组在此基础上给予急症行为干预。比较干预前后Gensini评分、血清妊娠相关血浆蛋白A(PAPP-A)水平、心功能指标和并发症发生率的组间和组内差异。结果干预后两组患者Gensini评分、血清PAPP-A水平均明显降低,且干预后观察组Gensini评分、血清PAPP-A表达水平均低于对照组(P<0.05)。干预后观察组心输出量水平明显高于对照组,而平均动脉压与心肌耗氧量水平明显低于对照组(P<0.05)。所有患者随访6个月,观察组患者非致命性心肌梗死、血运重建、恶性心律失常等并发症的发生率均低于对照组(P<0.05)。结论 ACS患者介入治疗术后急诊行为干预可有效降低PAPP-A表达水平与Gensini评分,提高心功能水平,减少并发症的发生。Objective To investigate the effects of emergency behavior intervention in patients with acute coronary syndrome（ACS）.Methods A total of 220 ACS patients were enrolled and randomly divided into observation group and control group,with 110 patients in each group.All patients were given standardized interventional treatment and western medicine drug therapy.Patients in control group were given conventional interventions,including bed rest and passively activities,Patients in observation group were further given emergency behavior interventions.Before and after interventions,Gensini scores,serum levels of pregnancy-associated plasma protein A（PAPP-A）,heart function and incidence rates of complications were compared.Results After interventions,Gensini scores and serum PAPP-A level were both decreased in observation group and control group,compared with those before interventions,and Gensini scores and serum PAPP-A level in observation group were lower than control group（P〈0.05）.After the intervention,cardiac output level in observation group was higher,but mean arterial blood pressure and myocardial volume of oxygen consumption levels were lower than control group（P〈0.05）.During the follow-up of six months,the incidence rates of non-fatal myocardial infarction,revascularization and malignant arrhythmias in observation group were lower than control group（P〈0.05）.Conclusion Emergency behavioral intervention in patients with ACS could effectively reduce serum PAPP-A level and Gensini scores,improve heart function and reduce the incidence of complications.

关 键 词：急诊行为干预 急性冠状动脉综合征 妊娠相关血浆蛋白A GENSINI评分 

分 类 号：R543.3[医药卫生—心血管疾病]