冠心病心力衰竭患者经皮冠状动脉介入治疗临床疗效评价  

Clinical effect of percutaneous coronary intervention in patients with coronary heart disease and heart failure

作　　者：葛婷爱[1] 周逸丹[1] GE Tingai;ZHOU Yidan(Department of Emergency,Hangzhou Third People's Hospital,Hangzhou 310009,China)

机构地区：[1]杭州市第三人民医院急诊科,浙江杭州310009

出　　处：《全科医学临床与教育》2022年第2期123-126,共4页Clinical Education of General Practice

摘　　要：目的研究经皮冠状动脉介入治疗(PCI)冠心病心力衰竭患者的临床疗效。方法选取71例冠心病射血分数降低合并心力衰竭并接受PCI的患者,根据术前心电图是否有缺血改变将患者分为心电图有缺血改变(A组)39例和心电图无缺血改变(B组)32例。另选取冠心病射血分数降低合并心力衰竭但给予常规药物治疗22例为对照组。比较三组患者出院前的心功能分级情况以及治疗后1周、1个月、3个月、6个月、12个月的左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、N末端脑钠肽前体(NT-proBNP)水平。结果A组患者出院前的心功能提高3级者比例高于B组和对照组,差异均有统计学意义(χ^(2)分别=9.65、7.58,P均<0.05)。A组和B组患者术后1个月、3个月、6个月、12个月的NT-proBNP值均低于对照组(t分别=-3.11、-2.14、-3.29、-2.03、-3.25、-2.04、-3.23、-2.05,P均<0.05),且A组患者术后3个月、6个月、12个月的NT-proBNP值均低于B组(t分别=-2.24、-2.05、-2.06,P均<0.05)。A组患者术后3个月、6个月、12个月的LVEF值均高于B组和对照组(t分别=2.32、3.39、2.39、4.22、5.44、4.36,P均<0.05),LVEDD值均低于B组和对照组(t分别=-2.43、-2.63、-2.75、-3.88、-4.45、-4.85,P均<0.05)。结论PCI治疗冠心病心力衰竭患者能有效改善心功能,有较好的临床疗效,尤其在心电图提示缺血性改变患者中效果更佳。Objective To study the clinical efficacy of percutaneous coronary intervention(PCI)in patients with coro-nary heart disease and heart failure.Methods Totally 71 patients with reduced ejection fraction of coronary heart disease complicated with heart failure and undergoing PCI were divided into ischemic changes in ECG(group A)and no ischemic changes in ECG(group B),and 22 patients with decreased ejection fraction of coronary heart disease complicated with heart failure were treated with conventional drugs were selected as the control group.The cardiac function grading before discharge and the levels of LVEF,LVEDD and NT-proBNP at 1 week,1 month,3 months,6 months and 12 months after treatment were compared among three groups.Results The proportion of patients in group A whose cardiac func-tion improved by grade 3 before discharge was higher than that in group B and control group,and the differences were statistically significant(χ^(2)=9.65,7.58,P<0.05).The NT-proBNP values in group A and B at 1 month,3 months,6 months and 12 months after operation were lower than those in control group(t=-3.11,-2.14,-3.29,-2.03,-3.25,-2.04,-3.23,-2.05,P<0.05).The NT-proBNP values in group A at 3 months,6 months and 12 months after operation were lower than those in group B(t=-2.24,-2.05,-2.06,P<0.05).The LVEF values in group A at 3 months,6 months and 12 months after operation were higher than those in group B and control group(t=2.32,3.39,2.39,4.22,5.44,4.36,P<0.05).The LVEDD values in group A at 3 months,6 months and 12 months after operation were lower than those in group B and control group(t=-2.43,-2.63,-2.75,-3.88,-4.45,-4.85,P<0.05).Conclusion PCI can effectively im-prove cardiac function in patients with coronary heart dis-ease complicated with heart failure,especially in patients with ischemic changes indicated by ECG.

关 键 词：冠心病 心力衰竭 介入治疗 缺血性改变 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]