溶栓后介入治疗对急性心肌梗死患者ST段下移及血管再通情况的影响  

Effect of interventional therapy after thrombolysis on ST segment decline and revascularization in patients with acute myocardial infarction

作　　者：杨涛[1] 张萍[2] 张勇 何新泽 Yang Tao;Zhang Ping;Zhang Yong;He Xinze(Department of Emergency Medicine,Binzhou Central Hospital,Binzhou 251700,China;Department of Neurology,Binzhou Central Hospital,Binzhou 251700,China)

机构地区：[1]山东省滨州市中心医院急诊科,251700 [2]山东省滨州市中心医院神经内科,251700

出　　处：《中国实用医刊》2021年第11期21-24,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨溶栓后介入治疗对急性心肌梗死(AMI)患者ST段下移及血管再通情况的影响。方法抽取滨州市中心医院2018年7月至2020年8月收治的100例AMI患者,按照治疗方法将其分为对照组与观察组,每组50例。对照组直接行经皮冠状动脉介入(PCI)治疗,观察组行静脉溶栓后PCI治疗。比较两组治疗后ST段下移率、血管再通状况及不良心脏事件(MACE)发生情况。比较两组治疗前及治疗后4周的心功能指标。结果治疗后,观察组ST段下移率(94.00%,47/50)与血管再通率(96.00%,48/50)均高于对照组(80.00%,40/50;82.00%,41/50),差异有统计学意义(P<0.05)。治疗后4周,两组左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)较治疗前降低,左室射血分数(LVEF)均较治疗前升高,且观察组改善幅度大于对照组(P<0.05)。两组均无心源性病死发生。两组MACE发生率比较差异未见统计学意义(P>0.05)。结论AMI患者采用静脉溶栓后PCI治疗临床效果显著,可有效提高ST段下移率与血管再通率,改善心功能,利于改善预后。Objective To investigate the effects of interventional therapy after thrombolysis on ST segment decline and revascularization in patients with acute myocardial infarction(AMI).Methods A total of 100 cases of AMI patients admitted to Binzhou Central Hospital from July 2018 to August 2020 were selected.And they were divided into control group and observation group according to their treatment methods,with 50 cases in each group.Control group received percutaneous coronary intervention(PCI).Observation group received intravenous thrombolysis firstly,and then underwent PCI.The ST segment decline rate,revascularization,and incidence of major adverse cardiovascular events(MACE)after treatment were compared between the two groups.And the preoperative and 4-week postoperative cardiac function indexes were compared between the two groups.Results After treatment,ST segment decline rate and revascularization rate of observation group were 94.00%(47/50)and 96.00%(48/50),respectively,higher than 80.00%(40/50)and 82.00%(41/50)of control group,and the differences were statistically significant(P<0.05).Compared with preoperative values,4-week postoperative left ventricular end-systolic diameter(LVESD)and left ventricular end-diastolic diameter(LVEDD)of both groups were lower,and the left ventricular ejection fraction(LVEF)values were higher,and the improvement of observation group was more significant than that of control group(P<0.05).Neither group had cardiac death.There was no significant difference in the incidence of MACE between the two groups(P>0.05).Conclusions PCI after intravenous thrombolysis has a significant clinical effect on AMI,which can effectively improve the ST segment decline rate and revascularization,and significantly improve cardiac function.Moreover,the incidence of MACE is low,which is beneficial to improve the prognosis of the disease.

关 键 词：急性心肌梗死 静脉溶栓 经皮冠状动脉介入 ST段下移 血管再通 

分 类 号：R542.22[医药卫生—心血管疾病]