介入治疗对老年急性心肌梗死合并血管病变病人的疗效及对血清VEGF、ox-LDL水平的影响  

Efficacy of interventional therapy and its effect on the serum levels of VEGF and ox-LDL in the elderly patients with acute myocardial infarction complicated with vascular disease

作　　者：谢芳[1] 董丹萍[1] 刘遵季[1] 郭自同[1] XIE Fang;DONG Dan-ping;LIU Zun-ji;GUO Zi-tong(Department of Cardiovascular Medicine,Xinjiang Autonomous Region People′s Hospital,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院心血管内科,新疆维吾尔自治区乌鲁木齐市830000

出　　处：《实用老年医学》2020年第11期1142-1145,共4页Practical Geriatrics

基　　金：新疆维吾尔自治区自然科学基金资助项目(2017D01C107)。

摘　　要：目的探讨介入治疗在老年急性心肌梗死合并血管病变病人中的疗效及对血清血管内皮生长因子(VEGF)、氧化型低密度脂蛋白(ox-LDL)水平的影响。方法选择2018年4月至2019年4月310例急性心肌梗死合并血管病变病人作为对象,随机分为对照组(n=155例)和观察组(n=155例)。对照组给予常规溶栓治疗,观察组采用介入治疗,1周后进行疗效评估,并比较2组心功能指标,血清VEGF、ox-LDL水平及预后。结果治疗后1周,2组心功能指标均有所改善,观察组舒张期室间隔厚度(IVST)、左心室舒张末期内径(LVDD)、左心室收缩末期内径(LVSD)水平低于对照组(P<0.05),LVEF水平高于对照组(P<0.05);观察组治疗后1周血清VEGF水平高于对照组(P<0.05),ox-LDL水平低于对照组(P<0.05);观察组治疗后再发心绞痛、消化道出血、心力衰竭、心律失常的发生率及死亡率低于对照组(P<0.05)。结论介入治疗能提高急性心肌梗死合并血管病变病人的心功能水平,改善血清VEGF、ox-LDL水平,能获得良好的治疗预后,值得推广应用。Objective To investigate the efficacy of interventional therapy and its effect on the serum levels of vascular endothelial growth factor(VEGF)and oxidized low density lipoprotein(ox-LDL)in the elderly patients with acute myocardial infarction(AMI)complicated with vascular disease.Methods A total of 310 patients with AMI complicated with vascular disease from April 2018 to April 2019 were randomly divided into control group and observation group,with 155 cases in each group.The control group was treated with conventional thrombolysis,and the observation group was treated with interventional therapy.The efficacy,cardiac function indicators,the serum levels of VEGF and ox-LDL and prognosis in the two groups were observed and compared.Results One week aftrer treatment,the cardiac function indicators were all improved in two groups.The levels of interventricular septal thickness(IVST),left ventricular diastolic dimension(LVDD)and left ventricular end-systolic diameter(LVSD)were significantly lower and the level of LVEF was higher in the observation group than those in the control group(P<0.05);The level of VEGF was significantly higher and the level of ox-LDL was lower in the observation group than that in the control group(P<0.05).The incidence of angina,gastrointestinal hemorrhage,heart failure,arrhythmia and death in the observation group after treatment were statistically lower than those in the control group(P<0.05).Conclusions Interventional therapy can improve the cardiac function and the serum levels of VEGF,ox LDL in the patients with AMI complicated with vascular disease,and can obtain a good prognosis,which is worth popularizing.

关 键 词：介入治疗 急性心肌梗死 血管病变 心功能 血管内皮生长因子 氧化型低密度脂蛋白 老年人 

分 类 号：R542.22[医药卫生—心血管疾病] R543[医药卫生—内科学]