右冠急性闭塞急诊PCI术后右心功能与再灌注时间的相关性研究  

Investigation on the correlation between right cardiac function and reperfusion time after emergency PCI for acute occlusion of right coronary artery

作　　者：余庆耀 罗小菊 陈一铭 YU Qingyao;LUO Xiaoju;CHEN Yiming(Department of Cardiovascular Medicine,the Second People’s Hospital in Shanwei City,Shanwei Yihui Fund Hospital,Guangdong,Shanwei 516600,China)

机构地区：[1]广东省汕尾市第二人民医院汕尾逸挥基金医院心内科,广东汕尾516600

出　　处：《中国医药科学》2023年第4期149-152,156,共5页China Medicine And Pharmacy

基　　金：广东省汕尾市科技计划项目(210528206342914)。

摘　　要：目的探究右冠急性闭塞急诊经皮冠状动脉介入术(PCI)术后右心功能与再灌注时间的相关性。方法选取2021年1月至2022年3月于汕尾市第二人民医院行急诊PCI的右冠状动脉闭塞导致的急性ST段抬高型心肌梗死(STEMI)患者100例,按照患者到医院的时间将其分为观察组和对照组,每组各50例。观察比较两组患者PCI术后冠状动脉血流情况和再灌注心律失常发生情况的差异,以及手术前后右心功能指标变化情况,分析右心功能和再灌注时间的相关性。所有患者均随访3个月,记录心血管不良事件的发生情况。结果两组PCI术后的冠状动脉血流等级比较,无显著差异。观察组PCI术后再灌注心律失常出现率(14.00%)显著高于对照组(2.00%),差异有统计学意义(P<0.05)。PCI术后,观察组的TAPSE大于对照组,Tei指数小于对照组,差异有统计学意义(P<0.05)。观察组心血管不良事件总发生率(6.00%)显著低于对照组(22.00%),差异有统计学意义(P<0.05)。TAPSE与再灌注时间呈正相关,Tei指数与再灌注时间呈负相关,差异有统计学意义(P<0.05)。结论右冠急性闭塞急诊PCI术后右心功能与再灌注时间具有明确相关性,再灌注时间越短,患者冠状动脉血流恢复越好,心肌缺血恢复越快,右心功能恢复越理想,不良事件发生概率越低,但同时,再灌注心律失常的发生率会升高。Objective To investigate the correlation between right cardiac function and reperfusion time after emergency percutaneous coronary intervention(PCI)for acute occlusion of right coronary artery.Methods A total of 100 patients with acute ST segment elevation myocardial infarction(STEMI)caused by right coronary artery occlusion who underwent emergency PCI in the Second People’s Hospital in Shanwei City from January 2021 to March 2022 were selected.And they were divided into the observation group(n=50)and the control group(n=50)according to the patients’arrival time in the hospital.The differences of coronary artery blood flow and reperfusion arrhythmia after PCI between the two groups of patients,and the changes of right cardiac function indices before and after operation were observed and compared.The correlation between right cardiac function and reperfusion time was analyzed.All patients were followed up for 3 months to record the occurrence of cardiovascular adverse events.Results There was no significant difference in coronary blood flow grade after PCI between the two groups.The incidence of reperfusion arrhythmia after PCI in the observation group was 14.00%,significantly higher than 2.00%in the control group,with statistically significant difference(P<0.05).After PCI,the TAPSE value of the observation group was higher than that of the control group,and the Tei index was lower than that of the control group,with statistically significant differences(P<0.05).The total incidence of postoperative cardiovascular adverse events in the observation group was 6.00%,significantly lower than 22.00%in the control group,with statistically significant difference(P<0.05).TAPSE was positively correlated with reperfusion time,while Tei index was negatively correlated with reperfusion time,with statistically significant differences(P<0.05).Conclusion There is a clear correlation between right cardiac function and reperfusion time after emergency PCI for acute occlusion of right coronary artery.T he shorter the reperfusion

关 键 词：右冠急性闭塞 急诊PCI 右心功能 再灌注时间 急性ST段抬高型心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]