不同时间窗冠状动脉介入对急性心肌梗死心肌酶、左室功能及远期预后的影响  

Influence of coronary intervention at different time windows on myocardial enzymes,left ventricular function and long-term prognosis of acute myocardial infarction

作　　者：高岩峰[1] 

机构地区：[1]内蒙古医科大学附属人民医院,内蒙古呼和浩特010020

出　　处：《转化医学电子杂志》2017年第1期41-44,共4页E-Journal of Translational Medicine

摘　　要：目的:研究不同时间窗冠状动脉介入对急性心肌梗死心肌酶、左室功能及远期预后的影响.方法:选取2010-05/2015-10在内蒙古医科大学附属人民医院确诊为急性心肌梗死并接受急诊经皮冠状动脉介入治疗的患者100例作为研究对象,根据治疗时间窗分为早期组(n=38)、中期组(n=33)、晚期组(n=29),接受PCI治疗的时间分别为<6 h、6~12 h、12~24 h,比较三组患者的心肌酶含量、心功能超声指标、远期预后情况.结果:心肌酶谱:早期组患者的血清肌酸激酶同工酶(CK-MB)、心肌钙蛋白T(cTnI)、心肌肌钙蛋白I(cTnI)含量明显低于中期组和晚期组,差异具有统计学意义(P<0.05);左心室功能:早期组患者左心室射血分数(LVEF)、每搏量(SV)、左室内径缩短率(LVFS)、室壁增厚率(△T)、室间隔运动幅度(AIS)均明显高于中期组和晚期组,差异具有统计学意义(P<0.05);预后:随访1年,早期组患者不稳定型心绞痛、再次心肌梗死、心律失常、心力衰竭等的发生率(18.42%)明显低于中期组(45.45%)与晚期组(51.72%),差异具有统计学意义(P<0.05).结论:患者于发病后6 h内早期进行介入治疗有助于减轻心肌细胞损伤、改善其左心室功能以及预后情况.AIM： To study the effect of coronary intervention at different time windows on myocardial enzymes,left ventricular function and long-term prognosis of acute myocardial infarction.METHODS： A total of 100 patients diagnosed with acute myocardial infarction and undergoing primary percutaneous coronary intervention admitted into People＇s Hospital Affiliated to Inner Mongolia Medical University from May 2010 to October 2015 were selected as the objects of study and divided into the early stage group,the middle stage group and late stage group according to the treatment time window. The time of getting PCI was less than 6hours,6 to 12 hours,and 12 to 24 hours. Then patient＇s cardiac enzymes,ultrasonic parameters of cardiac function, long-term prognosis were compared. RESULTS： Myocardial enzyme spectrum： the serum CK-MB,c Tn T,c Tn I content in early stage group were significantly lower than the middle stage group and late stage group,with statistically significant differences（ P 0. 05）; Left ventricular function： the LVEF,SV,LVFS,△T,AIS in early stage group were significantly higher than those of the middle stage group and late stage group,with statistically significant differences（ P0.05）; Prognosis： the patients were followed up for 1 year,the incidence of unstable angina pectoris,myocardial infarction once again,cardiac arrhythmias,heart failure,etc（ 18. 42%）were significantly lower than the middle stage group（ 45. 45%）and late stage group（ 51. 72%）, with statistically significant differences（ P 0. 05）. CONCLUSION： Early interventional treatment within 6 hours after the onset of acute myocardial infarction is helpful to reduce myocardial cell damage,improve left ventricular function and prognosis of patients.

关 键 词：急性心肌梗死 介入治疗 时间窗 左心室功能 心肌酶 

分 类 号：R542.22[医药卫生—心血管疾病]