直接经皮冠状动脉腔内成形术联合支架置入术对急性心肌梗死患者N末端脑钠肽前体及QT间期离散度的影响  

Effect of direct percutaneous transluminal coronary angioplasty combined with stent implantation on N-terminal pro-B type natriuretic peptide and QT dispersion in patients with acute myocardial infarction

作　　者：李江科 陈少军[1] 牛卫洲 LI Jiangke;CHEN Shaojun;NIU Weizhou(Department of CardiovasculaRMedicine,Huairou District Hospital of Traditional Chinese Medicine,Beijing,102400)

机构地区：[1]北京市怀柔区中医医院心血管内科,北京102400

出　　处：《实用临床医药杂志》2022年第3期13-16,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨直接经皮冠状动脉腔内成形术(PTCA)联合支架置入术对急性心肌梗死(AMI)患者N末端脑钠肽前体(NT-proBNP)及QT间期离散度(QTd)的影响。方法将100例AMI患者采取分层抽样法分为观察组(直接PTCA联合支架置入术治疗)和对照组(重组人组织型纤溶酶原激活物治疗),每组50例。比较2组NT-proBNP、QTd、1年内心绞痛发生率、再发心肌梗死率、病死率、左室舒张末期内径(LVEDd)、左室射血分数(LVEF)、左室收缩末期内径(LVESd)及并发症发生情况。结果治疗后,观察组的NT-proBNP、QTd低于对照组,差异有统计学意义(P<0.05)。观察组1年内心绞痛发生率、再发心肌梗死率低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组LVEDd、LVESd低于对照组,LVEF高于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率为4.00%,低于对照组的18.00%,差异有统计学意义(P<0.05)。结论直接PTCA联合支架置入术治疗AMI患者效果显著,可降低NT-proBNP水平、QTd数值及并发症发生率。Objective To investigate the effect of direct percutaneous transluminal coronary angioplasty(PTCA)combined with stent implantation on N-terminal pro-B type natriuretic peptide(NT-proBNP)and QT dispersion(QTd)in patients with acute myocardial infarction(AMI).Methods A total of 100 AMI patients were divided into observation group(treated by direct PTCA and stent implantation)and control group(treated by recombinant human tissue plasminogen activator)according to stratified sampling method,with 50 cases in each group.NT-proBNP,QTd,1-yeaRincidence of angina pectoris,recurrent myocardial infarction rate,mortality,left ventriculaRend diastolic diameteR(LVEDd),left ventriculaRejection fraction(LVEF),left ventriculaRend systolic diameteR(LVESd)and incidence of complications were compared between the two groups.Results AfteRtreatment,NT-proBNP and QTd in the observation group were significantly loweRthan those in the control group(P<0.05).The 1-yeaRincidence of angina pectoris and recurrent myocardial infarction rate in the observation group were significantly loweRthan those in the control group(P<0.05).AfteRtreatment,LVEDd and LVESd in the observation group were significantly loweRthan those in the control group,while LVEF was significantly higheRthan that in the control group(P<0.05).The total incidence of complications in the observation group was 4.00%,which was significantly loweRthan 18.00%in the control group(P<0.05).Conclusion Direct PTCA combined with stent implantation shows a significant effect in the treatment of patients with AMI,which can reduce the NT-proBNP,QTd and incidence of complications.

关 键 词：经皮冠状动脉腔内成形术 支架置入术 急性心肌梗死 N末端脑钠肽前体 QT间期离散度 心绞痛 

分 类 号：R542.2[医药卫生—心血管疾病] R730.8[医药卫生—内科学]