PCI、CCU对治疗急性ST段抬高型心肌梗死患者的临床意义  

Clinical Significance of Percutaneous Coronary Intervention and Coronary Care Unit in Treating ST-Segment Elevation Myocardial Infarction Patients

作　　者：杨宁[1] 司定然[1] 商惠萍[1] 王恒亮[1] 张金生[1] 

机构地区：[1]河南省濮阳市油田总医院心血管内科,河南濮阳457001

出　　处：《医学临床研究》2015年第12期2362-2365,共4页Journal of Clinical Research

摘　　要：[目的]探讨经皮冠状动脉介入术（PCI）及冠心病监护病房（CCU）对治疗急性ST段抬高型心肌梗死（STEMI）患者的临床意义。【方法】选择本院219例STEMI患者为研究对象，根据最终临床综合诊治情况及患者和家属意愿，将其分为急诊组、普通病床组、PCI组、CCU组、PCI＋CCU组。分别于入院d1、d2、d4检测各组血清肌酸激酶同工酶（CK—MB）、肌钙蛋白I（cTnI）、谷草转氨酶（AST）、谷丙转氨酶（ALT）、肌酐（Cr）水平，入院d10检测患者血清AST、ALT、Cr水平。所有患者入院d3-5行心脏彩超检查，记录其左室射血分数（LVEF）。【结果】入院d2各组患者血清CK—MB水平差异具有统计学意义（P=0．028％0．05）；入院d4各组患者血清cTnI、AST、ALT、Cr水平差异均具有统计学意义（均P〈0．05）。普通病床组、CCU组患者血清cTnI水平均显著高于PCI组、PCI＋CCU组；普通病床组的血清AST水平显著高于PCI组、PCI＋CCU组，差异均具有统计学意义（均P〈0．05）；PCI＋CCU组血清ALT水平显著低于普通病床组、CCU组；PCI＋CCU组血清Cr水平低于普通病床组、PCI组、CCU组；入院d10普通病床组血清ALT水平显著高于PCI组、CCU组、PCI＋CCU组；CCU组血清ALT水平显著高于PCI＋CCU组，差异均具有统计学意义（均P〈0．05）；普通病床组LVEF显著低于PCI组、CCU组、PCI＋CCU组。入院d10普通病床组的存活率显著低于PCI组、CCU组、PCI＋CCU组。【结论】急诊PCI术后收治至CCU病床是治疗STEMI患者的最佳方案。[Objective]To explore the significance of percutaneous coronary intervention （PCI） and coronary care unit （CCU） for ST-segment elevation myocardial infarction （STEMI）. [Methods]The 219 patients with STEMI were selected as research objects. According to the final clinical diagnosis and treatment as well as patients＂ and their family members＂ preference, the cases were divided into four groups： an emergency group, a general hospital beds group, a PCI group, a CCU group, and a PCI＋CCU group. Levels of serum creatine kinase isoenzyme （CK-MB）, troponin I （cTnI）, aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, and creatinine （CR） were detected on days 1, 2, and 4 after admission to hospital. Serum AST, ALT, and CR levels were detected on day 10. All patients underwent a heart color Doppler ultrasound examination to record their left ventricular ejection fraction （LVEF） day 3 to day 5 after admission to the hospital. [Results]There were significant differences in serum CK-MB levels among patients of different groups on D2 （ P =0.028〈0.05）. The levels of serum cTnI, ALT, AST and CR were significantly different among the patients on D4; the differences were statistically significant （ P 〈0.05）. The serum levels of cTnI were significantly higher in patients of the CCU group and general hospital beds group than in patients of the PCI and PCI＋CCU groups （ P 〈0.05）. Also, AST levels of patients in the general hospital beds group were higher than those of patients in the PCI and PCI＋CCU groups （ P 〈0.05）. In addition, ALT levels of the patients in the PCI＋CCU group were lower than those of patients in the general hospital beds and CCU group, and CR levels of those in the PCI＋CCU group were lower than those of patients in the general hospital beds group and the CCU group as well. On D10, ALT levels of patients in the general hospital beds group were higher than those of patients in the PCI, CCU, and PCI＋CCU group, although levels of

关 键 词：心肌梗死/外科学 急性病 血管成形术 经腔 经皮冠状动脉 冠心病重症监护病房 存活率 

分 类 号：R542.22[医药卫生—心血管疾病]