早期干预重度狭窄的非IRA在多支冠脉病变的STEMI患者中的应用价值分析  

Analysis of the Application Value of Early Intervention of Non-IRA with Severe Stenosis in STEMI Patients with Multivessel Coronary Disease

作　　者：赵笑雯 朱肖霖 ZHAO Xiaowen;ZHU Xiaolin(Department of Cardiology,Zhengzhou Seventh People's Hospital,Zhengzhou 450016 China)

机构地区：[1]郑州市第七人民医院心内科,郑州450016

出　　处：《内蒙古医学杂志》2023年第11期1306-1309,共4页Inner Mongolia Medical Journal

摘　　要：目的探讨多支冠脉病变的急性ST段抬高心肌梗死(STEMI)患者在行梗死相关冠脉(IRA)急诊经皮冠状动脉介入术(PCI)后,对重度狭窄的非IRA进行早期干预的临床效果。方法选取2020年11月至2021年12月本院收治的70例STEMI患者,根据患者治疗方案分为非IRA干预组(32例)和单纯IRA干预组(38例)。非IRA干预组在行PCI术后1周对非IRA重度狭窄冠脉实行干预;单纯IRA干预组仅实行PCI术。收集两组临床相关资料,包含基础信息、治疗情况、血清生化指标、住院期间和随访期间不良事件发生情况。对比两组间差异。结果非IRA干预组的置入支架数量多于单纯IRA干预组,住院时间长于单纯IRA干预组,差异有统计学意义(P<0.05)。非IRA干预组术后BNP水平低于单纯IRA干预组,差异有统计学意义(P<0.05)。两组住院期间不良事件发生率比较,差异无统计学意义(P>0.05);随访期间,非IRA干预组靶血管血运重建、反复性心绞痛发生率低于单纯IRA干预组,差异有统计学意义(P<0.05)。结论早期对急性STEMI多支冠脉病变患者重度狭窄非IRA进行干预具有较好的临床效果及安全性,可有效改善患者的心肌功能及预后,较单纯IRA干预受益更多。Objective To investigate the early treatment of severe stenosis non-IRA in patients with acute ST-segment elevation myocardial infarction(STEMI)with multi-vessel coronary artery disease after emergency percutaneous coronary intervention(PCI)in infarction-related coronary artery(IRA).Clinical effect of the intervention.Methods A total of 70 patients with STEMI who were admitted to our hospital from November 2020 to December 2021 were selected and divided into non-IRA intervention group(32 cases)and pure IRA intervention group(38 cases)according to the patient's treatment plan.In the non-IRA group,intervention was performed on the non-IRA severely stenotic coronary arteries 1 week after PCI;in the simple IRA group,only PCI was performed.The clinical related data of the two groups of patients were collected,including basic information,treatment-related,serum biochemical indicators,and adverse events during hospitalization and follow-up.Compare the differences between the two groups.Results The number of stents in the non-IRA intervention group was more than that in the simple IRA intervention group,and the hospital stay was longer than that in the simple IRA intervention group(P<0.05).The postoperative BNP level in the non-IRA intervention group was lower than that in the simple IRA intervention group(P<0.05).There was no difference in the incidence of adverse events during hospitalization between the two groups(P>0.05).During the follow-up period,the incidences of target vessel revascularization and recurrent angina pectoris in the non-IRA intervention group were lower than those in the simple IRA intervention group(P<0.05).Conclusion Early intervention for severe stenosis and non-IRA in patients with acute STEMI multivessel coronary artery disease has good efficacy and safety,and can effectively improve the myocardial function and prognosis of patients,which is more beneficial than simple IRA intervention.

关 键 词：多支冠脉病变 急性ST段抬高心肌梗死 非梗死相关 重度狭窄 早期干预 

分 类 号：R541.4[医药卫生—心血管疾病]