基于不同时间窗下延迟经皮冠状动脉介入治疗急性ST段抬高型心肌梗死患者的效果  

Effect of Delayed Percutaneous Coronary Intervention in Patients with Acute ST-segment Elevation Myocardial Infarction under Different Time Windows

作　　者：贾亚炜 刘正锋 王广东[1] 靳文清 张远征[1] JIA Yawei;LIU Zhengfeng;WANG Guangdong;JIN Wenqing;ZHANG Yuanzheng(Department of Cardiology,Tianshui First People's Hospital,Tianshui,Gansu Province,741000 China)

机构地区：[1]天水市第一人民医院心内科,甘肃天水741000

出　　处：《世界复合医学》2023年第10期156-159,共4页World Journal of Complex Medicine

摘　　要：目的针对急性ST段抬高型心肌梗死患者,探讨分析在不同时间窗下实施延迟经皮冠状动脉介入术(percutaneous coronary intervention,PCI)治疗的效果。方法选取2020年5月—2022年5月天水市第一人民医院诊疗的100例急性ST段抬高型心肌梗死患者(发病时间>12 h)进行回顾性分析研究,根据接受PCI治疗时间窗的差异性分为两组,时间窗在12~24 h内接受治疗的50例纳入观察组,时间窗在24 h~7 d内接受治疗的50例纳入对照组。对比分析两组患者手术前后的心功能改善情况,统计两组患者支架置入情况和不良心血管事件发生率。结果术后8周,观察组左室舒张末期内径(43.08±5.72)mm、左室收缩末期内径(30.48±3.41)mm低于对照组的(47.63±5.96)mm、(34.27±4.19)mm,左室射血分数(54.85±4.68)%高于对照组的(51.34±4.93)%,差异有统计学意义(P<0.05);两组患者支架植入数量、支架长度、支架直径及最大扩张力对比,差异无统计学意义(P>0.05);随访1年,观察组不良心血管事件发生率12.00%低于对照组的30.00%,差异有统计学意义(χ^(2)=4.883,P<0.05)。结论急性ST段抬高型心肌梗死患者在时间窗12~24 h内接受PCI治疗较时间窗24 h~7 d的治疗效果更为理想,可有效改善患者心功能,降低术后不良心血管事件的发生率。Objective To investigate the effect of delayed percutaneous coronary intervention(PCI)in patients with acute ST elevation myocardial infarction under different time windows.Methods A retrospective study was conducted on one hundred patients with acute ST-segment elevation myocardial infarction(onset time exceeding 12 h)diagnosed and treated in Tianshui First People's Hospital from May 2020 to May 2022.According to the difference of PCI treatment time window,50 cases receiving PCI treatment within 12 to 24 h were included in the observation group,and 50 cases receiving PCI treatment within 24 h to 7 d were included in the control group.The improvement of cardiac function before and after operation was compared between the two groups,and the incidence of stent placement and adverse cardiovascular events were analyzed.Results At 8 weeks after operation,the left ventricular end-diastolic diameter(43.08±5.72)mm and the left ventricular end-systolic diameter(30.48±3.41)mm in the observation group were lower than those in the control group(47.63±5.96)mm and(34.27±4.19)mm.Left ventricular ejection fraction(54.85±4.68)%was higher than that of control group(51.34±4.93)%,and the difference was statistically significant(P<0.05).There were no significant differences in stent implantation number,stent length,stent diameter and maximum expansion tension between the two groups(P>0.05).After 1 year of follow-up,the incidence of adverse cardiovascular events in the observation group(12.00%)was lower than that in the control group(30.00%),and the difference was statistically significant(χ^(2)=4.883,P<0.05).Conclusion Patients with acute ST-segment elevation myocardial infarction who receive PCI within a time window of 12 to 24 h have a better therapeutic effect than those with a time window of 24 h to 7 d,which can effectively improve the cardiac function of patients and reduce the incidence of postoperative adverse cardiovascular events.

关 键 词：心肌梗死 经皮冠状动脉介入术 时间窗 心功能 心血管事件 

分 类 号：R542[医药卫生—心血管疾病]