经皮冠状动脉腔内成形术治疗急性心肌梗死的效果及对内皮功能和心功能的影响  

Effect of percutaneous transluminal coronary angioplasty on acute myocardial infarction and its influence on endothelial function and cardiac function

作　　者：张月婷[1] 李新春 关玲霞 冯世军 李鹏[4] Zhang Yueting;Li Xinchun;Guan Lingxia;Feng Shijun;Li Peng(Interventional Examination Room,Zhumadian Central Hospital Affiliated to Huanghuai University,Zhumadian 463000,China;Department of Cardiology,Zhumadian Central Hospital Affiliated to Huanghuai University,Zhumadian 463000,China;Department of Cardiac Macro Vascular Surgery,Zhumadian Central Hospital Affiliated to Huanghuai University,Zhumadian 463000,China;Department of Emergency,Zhumadian Central Hospital Affiliated to Huanghuai University,Zhumadian 463000,China)

机构地区：[1]黄淮学院附属驻马店市中心医院介入手术室,驻马店463000 [2]黄淮学院附属驻马店市中心医院心血管内一科,驻马店463000 [3]黄淮学院附属驻马店市中心医院心脏大血管外科,驻马店463000 [4]黄淮学院附属附属驻马店市中心医院急诊科,驻马店463000

出　　处：《中华实验外科杂志》2023年第4期738-741,共4页Chinese Journal of Experimental Surgery

摘　　要：目的探讨经皮冠状动脉腔内成形术(PTCA)治疗急性心肌梗死(AMI)的效果及对内皮功能和心功能的影响。方法选取2020年5月至2022年9月黄淮学院附属驻马店市中心医院收治的98例急性心肌梗死患者作为研究对象,采用随机数字表法将患者分为对照组和PTCA组,每组患者各49例。PTCA组患者实施PTCA进行治疗,对照组患者则给予常规静脉溶栓治疗。比较两组患者治疗后的临床疗效及不良事件发生。采用超声心动图检测两组患者左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)、左心室射血分数(LVEF)水平;采用一氧化氮(NO)、内皮素-1(ET-1)、血管性假血友病因子(vWF)检测试剂盒检测两组患者血清NO、ET-1、vWF水平。组间计量数据比较采用t检验。结果PTCA组患者的临床治疗总有效率[46例(93.88%)]明显高于对照组患者[38例(77.55%)],差异有统计学意义(t=5.333,P<0.05)。PTCA组患者LVEDV[(136.01±4.46)ml]、LVESV[(69.68±2.06)ml]水平明显低于对照组患者LVEDV[(155.24±4.87)ml]、LVESV水平[(82.41±2.37)ml],差异有统计学意义(t=20.41、28.36,P<0.05);PTCA组患者LVEF[(59.60±2.12)%]水平明显高于对照组患者[(50.67±1.47)%],差异有统计学意义(t=24.25,P<0.05)。PTCA组患者血清NO浓度[(62.31±3.53)μmol/L]明显高于对照组患者[(49.93±2.78)μmol/L],差异有统计学意义(t=19.30,P<0.05);PTCA组患者血清ET-1浓度[(62.37±2.91)ng/L]、vWF浓度[(6.64+0.26)ng/ml]明显低于对照组患者血清ET-1浓度[(72.73±2.68)ng/L]、vWF浓度[(8.01±0.21)ng/ml],差异有统计学意义(t=18.34、29.26,P<0.05)。PTCA组患者治疗后不良事件的总发生率[3例(6.12%)]明显低于对照组患者[8例(20.41%)],差异有统计学意义(t=4.188,P<0.05)。结论PTCA的实施可显著提升急性心肌梗死的临床治疗疗效,有效改善患者的心功能和血管内皮功能,并降低患者的不良事件发生率。Objective To investigate the effect of percutaneous transluminal coronary angioplasty(PTCA)on acute myocardial infarction(AMI)and its influence on endothelial function and cardiac function.Methods A total of 98 patients with AMI admitted to our hospital from May 2020 to September 2022 were selected as research objects.The patients were divided into control group and PTCA group by random number table method,with 49 patients in each group.PTCA was performed in the PTCA group,and conventional intravenous thrombolysis was performed in the control group.The clinical efficacy and adverse events were compared between the two groups after treatment.The levels of left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)and left ventricular ejection fraction(LVEF)in two groups were detected by echocardiography.Nitric oxide(NO),endothelin-1(ET-1)and von willebrand factor(vWF)kits were used to detect serum levels of NO,ET-1 and vWF in the two groups.The measurement data between groups were compared using a t-test.Results The total effective rate in the PTCA group[46 cases(93.88%)]was significantly higher than that in the control group[38 cases(77.55%),t=5.333,P<0.05].The LVEDV[(136.01±4.46)ml]and LVESV[(69.68±2.06)ml]in the PTCA group were significantly lower than those in the control group[(155.24±4.87)ml,(82.41±2.37)ml,t=20.41,28.36,P<0.05].The LVEF in the PTCA group[(59.60±2.12)%]was significantly higher than that in the control group[(50.67±1.47)%,t=24.25,P<0.05].The serum NO concentration in the PTCA group[(62.31±3.53)μmol/L]was significantly higher than that in the control group[(49.93±2.78)μmol/L,t=19.30,P<0.05].The concentrations of serum ET-1[(62.37±2.91)ng/L]and vWF[(6.64+0.26)ng/ml]in the PTCA group were significantly lower than those in the control group[(72.73±2.68)ng/L,(8.01±0.21)ng/ml,t=18.34,29.26,P<0.05].The total incidence of adverse events after treatment in PTCA group[3 cases(6.12%)]was significantly lower than that in control group[8 cases(20.41%),t=4.188,P<0.0

关 键 词：经皮冠状动脉腔内成形术 急性心肌梗死 心功能 血管内皮功能 

分 类 号：R542.22[医药卫生—心血管疾病]