急性心肌梗死患者急诊ICU静脉溶栓治疗的有效性及对溶栓时间、血管再通率的影响  

Effectiveness of intravenous thrombolytic therapy in emergency ICU for patients with acute myocardial infarction and its influence on thrombolysis time and vascular recanalization rate

作　　者：唐传雯 闵可梅[1] 徐月红[1] TANG Chuan-wen;MIN Ke-mei;XU Yue-hong(Department of Intensive Care Medicine,Nanjing Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing Jiangsu 210014,China)

机构地区：[1]南京市中西医结合医院重症监医学科,江苏南京210014

出　　处：《临床和实验医学杂志》2021年第2期158-161,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省卫生厅重点科研项目(编号:K201104)。

摘　　要：目的探讨急性心肌梗死患者急诊ICU静脉溶栓治疗的有效性及对溶栓时间、血管再通率的影响。方法前瞻性选取2018年1月至2019年12月南京市中西医结合医院心内科收治的50例急性心肌梗死患者作为对照组,选取同时期急诊ICU收治的50例急性心肌梗死患者作为研究组。对照组行心内科静脉溶栓治疗,研究组行急诊ICU静脉溶栓治疗。比较2组患者胸痛缓解时间、溶栓时间、血管再通率、治疗有效性、心肌损伤程度、心功能、并发症。结果研究组患者胸痛缓解时间、溶栓时间分别为(2.8±0.7)h、(41.2±18.4)min,均短于对照组[(15.4±8.3)h、(176.3±34.3)min],血管再通率84.0%高于对照组(48.0%),差异有统计学意义(P<0.05);研究组患者有效率98.0%高于对照组(74.0%),差异有统计学意义(P<0.05);研究组CK-MB达峰值时间[(10.6±2.0)h]短于对照组[(13.1±2.8)h],肌钙蛋白I(cTnI)峰值[(14.7±3.3)ng/mL]低于对照组[(18.8±4.5)ng/mL],左室射血分数(LVEF)值[(55.4±9.4)%]大于对照组[(50.4±11.1)%],差异有统计学意义(P<0.05);研究组发生心律失常、死亡、出血的概率分别为2.0%、0.0%、2.0%,均高于对照组(20.0%、10.0%、20.0%),差异有统计学意义(P<0.05)。结论急性心肌梗死患者行急诊ICU静脉溶栓治疗,患者生命安全得到较大保障,患者死亡率显著降低,改善患者心功能,减轻心肌损伤,治疗效果明显提高,效果确切,值得推广应用。Objective To investigate the effectiveness of intravenous thrombolytic therapy in emergency ICU for patients with acute myocardial infarction and its effect on thrombolysis time and vascular recanalization rate.Methods Fifty patients with acute myocardial infarction admitted to Nanjing Hospital of Integrated Traditional Chinese and Western Medicine Department of Cardiology from January 2018 to December 2019 were selected as the control group,and 50 patients with acute myocardial infarction admitted to the emergency ICU during the same period were selected as the study group.The control group received intravenous thrombolysis in cardiology,and the study group received intravenous thrombolysis in emergency ICU.The time of chest pain relief,thrombolysis time,vascular recanalization rate,treatment effectiveness,degree of myocardial injury,cardiac function,and complications were compared between the two groups.Results The chest pain relief time and thrombolytic time in the study group were(2.8±0.7)h and(41.2±18.4)min,respectively,which were shorter than those in the control group[(15.4±8.3)h,(176.3±34.3)min],and the recanalization rate 84.0%was higher than the control group(48.0%),the differences were statistically significant(P<0.05).The effective rate of the study group 98.0%was higher than the control group(74.0%),the difference was statistically significant(P<0.05).The peak time of CK-MB[(10.6±2.0)h]in the study group was shorter than the control group[(13.1±2.8)h],and the peak value of cTnI[(14.7±3.3)ng/mL]was lower than the control group[(18.8±4.5)ng/mL],the LVEF value[(55.4±9.4)%]was greater than the control group[(50.4±11.1)%],the differences were statistically significant(P<0.05).The probability of arrhythmia,death,and bleeding in the study group were respectively 2.0%,0.0%,2.0%,which were higher than the control group(20.0%,10.0%,20.0%),the differences were statistically significant(P<0.05).Conclusion Patients with acute myocardial infarction undergoing emergency ICU intravenous thrombolytic therap

关 键 词：急性心肌梗死 心肌损伤 静脉溶栓 急诊ICU 血管再通率 

分 类 号：R542.22[医药卫生—心血管疾病]