PCI不同时间窗对急性NSTEMI合并室壁瘤患者室壁瘤逆转及血清NT-proBNP、cTnI水平的影响  

Effect of Different Time Windows of PCI on Ventricular Aneurysm Reversion and Serum NT-proBNP and cTnI Levels in Patients with Acute NSTEMI Combined with Ventricular Aneurysm

作　　者：张超[1] 王小兵[1] 段丙军[1] ZHANG Chao;WANG Xiaobing;DUAN Bingjun(Department of Cardiovascular Medicine,the First People's Hospital of Neijiang,Neijiang 641000,China)

机构地区：[1]内江市第一人民医院心血管内科,四川内江641000

出　　处：《医学综述》2021年第9期1824-1829,共6页Medical Recapitulate

摘　　要：目的探究经皮冠状动脉介入术(PCI)不同时间窗对急性非ST段抬高型心肌梗死(NSTEMI)合并室壁瘤患者室壁瘤逆转及血清N端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)水平的影响。方法选取2017年5月至2019年3月内江市第一人民医院收治的107例急性NSTEMI合并室壁瘤患者作为研究对象,根据PCI介入时间不同分为A组(发病至PCI介入治疗时间<6 h,29例)、B组(6 h≤发病至PCI介入治疗时间<12 h,35例)、C组(发病至PCI介入治疗时间≥12 h,43例)。统计三组术后7 d、术后6个月相角程、半高宽、相位标准差、左心室射血分数,术后7 d反常容积指数(PVI)、术后6个月反常容积消失率,入院时、术后3、7 d的NT-proBNP、cTnI、非对称性二甲基精氨酸(ADMA)、纤溶酶原激活物抑制物1(PAI-1)水平,三组术后1年主要不良心血管事件(MACE)发生率。结果C组术后7 d和6个月相角程、相位标准差、半高宽高于A、B组,C组左心室射血分数低于A组和B组(P<0.05)。B组和C组术后7 d PVI高于A组[(19.16±3.41)、(19.52±3.14)比(17.45±2.63)](P<0.05),术后6个月反常容积消失率低于A组[25.71%(9/35)、13.95%(6/43)比62.07%(18/29)](P<0.05)。术后3、7 d,B组和C组NT-proBNP、cTnI、ADMA、PAI-1水平高于A组,C组高于B组(P<0.05)。C组MACE总发生率高于A组和B组[34.88%(15/43)比10.34%(3/29)、14.29%(5/35)](P<0.05)。结论急性NSTEMI合并室壁瘤患者早期及时接受PCI治疗,复通梗死动脉,可有效逆转室壁瘤形成,显著降低ADMA、PAI-1、NT-proBNP、cTnI水平,减少MACE发生。Objective To explore the effects of percutaneous coronary intervention(PCI)in different time windows on the reversal of ventricular aneurysm and serum N-terminal pro-brain natriuretic peptide(NT-proBNP)and cardiac troponin I(cTnI)levels in patients with acute non-ST-segment elevation myocardial infarction(NSTEMI)combined with ventricular aneurysm.Methods A total of 107 patients with acute NSTEMI combined with ventricular aneurysm admitted to the First People's Hospital of Neijiang from May 2017 to Mar.2019 were included for a prospective study.They were divided into three groups:group A(onset to PCI intervention time<6 h,29 cases),group B(6 h≤onset to PCI intervention time<12 h,35 cases),and group C(onset to PCI intervention≥12 h,43 cases)according to the difference of PCI intervention time.The phase shift,full width at half maxima,phase standard deviation,and left ventricular ejection fraction at 7 days and 6 months after surgery,plethysmographic variability index(PVI)at 7 days after surgery and the disappearance rate of PVI at 6 months after surgery,NT-proBNP,cTnI,plasma asymmetric dimethylarginine(ADMA)and plasminogen activator inhibitor-1(PAI-1)levels at admission,3 and 7 days after surgery,and the incidence of major adverse cardiovascular events(MACE)within 1 year after surgery of the three groups were recorded.Results The phase shift,phase standard deviation,full width at half maxima at 7 days and 6 months after surgery in the group C were higher than those in the group A and B,and the left ventricular ejection fraction was lower than that in the group A and B(P<0.05).The PVI of the group B and C was higher than that of the group A on the 7th day after surgery[(19.16±3.41),(19.52±3.14)vs(17.45±2.63)](P<0.05),and the disappearance rate of PVI was lower than that of the group A[25.71%(9/35),13.95%(6/43)vs 62.07%(18/29)](P<0.05).At 3 and 7 days after surgery,the NT-proBNP,cTnI,ADMA and PAI-1 levels of the group B and C were higher than those of the group A,and the group C was higher than the group B(P<0

关 键 词：急性非ST段抬高型心肌梗死 室壁瘤 经皮冠状动脉介入术 室壁瘤逆转 N端脑钠肽前体 心肌肌钙蛋白I 

分 类 号：R542.22[医药卫生—心血管疾病]