经桡动脉途径介入治疗老年冠心病合并慢性心力衰竭的疗效观察  

Efficacy observation of transradial intervention in the treatment of chronic heart failure with coronary artery disease in the elderly

作　　者：黎月琴 许红莲 LI Yue-qin;XU Hong-lian(Department of Cardiovascular Endocrinology,Beitun Hospital of the 10th Division of the Production and Construction Corps of the Uygur Autonomous Region,Altai 836000,China)

机构地区：[1]新疆维吾尔自治区生产建设兵团第十师北屯医院心血管内分泌科,836000

出　　处：《中国现代药物应用》2023年第15期1-6,共6页Chinese Journal of Modern Drug Application

摘　　要：目的观察老年冠心病合并慢性心力衰竭应用经桡动脉途径介入治疗的临床疗效。方法50例老年冠心病合并慢性心力衰竭患者,随机分为实验组和对比组,各25例。对比组应用经股动脉途径介入治疗,实验组应用经桡动脉途径介入治疗。比较两组患者临床疗效、手术指标、术后并发症发生情况及治疗前后美国纽约心脏病学会(NYHA)心功能分级、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、心率、左室射血分数(LVEF)、心输出量(CO)、每搏输出量(SV)、舒张早期心室充盈速度峰值(E峰)与舒张晚期心室充盈速度峰值(A峰)的比值(E/A)、N末端B型利钠肽前体(NT-proBNP)、血压、心理状态、生活质量、炎症因子指标[超敏C反应蛋白(hs-CRP)、B型脑利钠肽(BNP)]、血管内皮功能指标[一氧化氮(NO)、内皮素-1(ET-1)、肱动脉非内皮依赖性血管舒张功能(NMD)、肱动脉血流介导的血管舒张功能(FMD)、肱动脉峰值流速变化率]及6 min步行试验(6MWT)。结果实验组患者治疗总有效率92.00%高于对比组的68.00%,差异有统计学意义(P<0.05)。两组患者手术时间比较差异无统计学意义(P>0.05);实验组患者穿刺时间(4.36±1.26)min、X线曝光时间(41.16±8.37)min、术后卧床时间(3.16±1.05)d及住院时间(7.53±1.10)d均短于对比组的(11.97±1.51)min、(48.84±8.53)min、(6.72±1.53)d、(13.51±2.17)d,差异有统计学意义(P<0.05)。治疗后,两组患者NYHA心功能分级、LVESD、LVEDD、心率均优于本组治疗前,差异有统计学意义(P<0.05)。治疗后,两组患者LVEF、CO、SV均优于本组治疗前,差异有统计学意义(P<0.05)。治疗后,两组患者E/A、NT-proBNP均优于本组治疗前,差异有统计学意义(P<0.05);两组患者收缩压、舒张压与治疗前比较,差异无统计学意义(P>0.05)。治疗后,实验组患者E/A(1.23±0.08)优于对比组的(0.94±0.11),差异有统计学意义(P<0.05);两组患者NT-proBNP、收缩�Objective To observe the clinical efficacy of transradial intervention in the treatment of chronic heart failure with coronary artery disease in the elderly.Methods A total of 50 elderly patients with coronary heart disease and chronic heart failure were randomly divided into experimental group and comparison group,with 25 cases in each group.The comparison group was treated with transfemoral intervention,while the experimental group was treated with transradial intervention.Both groups were compared in terms of clinical efficacy,surgical index,postoperative complications,New York Heart Association(NYHA)cardiac function grading,left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),heart rate,left ventricular ejection fraction(LVEF),cardiac output(CO),stroke volume(SV),ratio of peak mitral flow velocity in early diastole(peak E)to peak mitral flow velocity in late diastole(peak A)(E/A),N-terminal pro-B-type natriuretic peptide(NT-proBNP),blood pressure,mental state,quality of life,inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),B-type natriuretic peptide(BNP)],vascular endothelial function indicators[nitric oxide(NO),endothelin-1(ET-1),nitroglycerin-mediated dilation(NMD),flow-mediated dilatation(FMD),brachial artery peak velocity variation],and 6 min walking test(6MWT)before and after treatment.Results The total effective rate of the experimental group was 92.00%,which was higher than that of 68.00%of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in operative time between the two groups(P>0.05).In the experimental group,the puncture time was(4.36±1.26)min,the X-ray exposure time was(41.16±8.37)min,the postoperative bed time was(3.16±1.05)d,and the hospital stay was(7.53±1.10)d,which were shorter than those of(11.97±1.51)min,(48.84±8.53)min,(6.72±1.53)d,and(13.51±2.17)d in the control group,and the differences were statistically significant(P<0.05).After treatment,NYHA card

关 键 词：冠心病 慢性心力衰竭 经桡动脉途径 经股动脉途径 介入治疗 心功能 

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