溶栓介入联合治疗对急性心肌梗死患者术后血清cTnI、BNP、PCT水平及生存质量的影响  

Effects of thrombolysis combined with interventional therapy on postoperative serum cardiac troponin,brain natriuretic peptide,procalcitonin levels and quality of life in patients with acute myocardial infarction

作　　者：刘倩梅 齐强[2] 张艳 刘净敏 陈云肖 Liu Qianmei;Qi Qiang;Zhang Yan;Liu Jingmin;Chen Yunxiao(Department of Cardiac Intensive Care Medicine,the First Central Hospital of Baoding City,Baoding 071000,China;Department of Cardiology,the First Central Hospital of Baoding City,Baoding 071000,China;Outpatient Department,the Fourth Retired Cadre Rest Center of Baoding,Hebei Military Region of the PLA,Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院心脏重症医学科,071000 [2]河北省保定市第一中心医院心内三科,071000 [3]解放军河北省军区保定第四离职干部休养所门诊部,071000

出　　处：《心脑血管病防治》2024年第4期24-27,31,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：河北省保定市科技局(3202040)。

摘　　要：目的探讨溶栓介入联合治疗策略在急性心肌梗死(AMI)患者中的应用效果。方法选取2019年1月至2021年10月保定市第一中心医院收治的AMI患者94例,按照不同治疗方法分为两组各47例,单纯经皮冠状动脉介入治疗(PCI)组入院90 min内接受PCI手术;联合组先给予溶栓干预,再行PCI手术。记录两组梗死相关血管再通、ST段下移、支架植入情况;比较两组心功能指标、肌钙蛋白I、脑钠肽、降钙素原水平以及并发症;出院后6个月随访评估预后情况及生活质量。结果联合组梗死相关血管再通患者比例、ST段下移患者比例均高于单纯PCI组,差异有统计学意义(χ^(2)=7.231、21.226,P<0.05);联合组治疗后左心室收缩末内径、左心室舒张末内径、左心室短轴缩短率低于PCI组,左心室射血分数高于单纯PCI组,差异有统计学意义(t=2.621、4.324、9.020、5.556,P<0.05);联合组治疗后肌钙蛋白I、脑钠肽、降钙素原低于PCI组,差异有统计学意义(t=5.966、12.546、6.903,P<0.05);联合组并发症发生率与PCI组差异无统计学意义(χ^(2)=0.224,P>0.05);术后6个月随访,联合组再梗死率、再发心绞痛率、复住院率低于PCI组,差异有统计学意义(χ^(2)=4.178、4.065、3.887,P<0.05);联合组治疗后健康状况调查问卷总分高于PCI组,差异有统计学意义(t=7.899,P<0.05)。结论溶栓与介入联合应用治疗AMI患者能够改善治疗效果与预后,提高患者生活质量。Objective To investigate the effect of thrombolysis combined with interventional therapy in patients with acute myocardial infarction(AMI).Methods Ninety-four patients with AMI admitted to the First Central Hospital of Baoding City from January 2019 to October 2021 were randomly divided into two groups,with 47 patients in each group.The percutaneous coronary intervention(PCI)group underwent PCI surgery within 90 minutes after admission,while the thrombolysis group received thrombolysis intervention first and then underwent PCI surgery.Infarct-related vascular recanalization,ST segment depression and stent implantation were recorded for both groups.Cardiac function indexes,troponin I,brain natriuretic peptide,procalcitonin levels and complications were compared between the two groups.The prognosis and quality of life were evaluated during a 6-month follow-up after discharge.Results The proportion of patients with infarct-related vascular recanalization and ST segment depression in the thrombolysis group were higher than those in the PCI group,with statistical significance(χ^(2)=7.231,21.226;P<0.05).The left ventricular end-systolic diameter,left ventricular enddiastolic diameter,and left ventricular short-axis shortening fraction in the thrombolysis group were lower than those in the PCI group,while the left ventricular ejection fraction was higher than that in the PCI group,with statistical significance(t=2.621,4.324,9.020,5.556;P<0.05).The post-treatment levels of troponin I,brain natriuretic peptide and procalcitonin in the thrombolysis group were lower than those in the PCI group,with statistically significant differences(t=5.966,12.546,6.903;P<0.05).There was no significant difference in the incidence of complications between the thrombolysis group and the PCI group(χ^(2)=0.224,P>0.05).In the 6-month follow-up,the rates of recurrent infarction,recurrent angina pectoris and re-hospitalization in the thrombolysis group were lower than those in the PCI group,with statistically significant differences(χ^(2)=4.

关 键 词：溶栓治疗 介入治疗 心肌梗死 生化指标 生活质量 

分 类 号：R542.22[医药卫生—心血管疾病]