不同时间窗行择期经皮冠状动脉介入治疗对ST段抬高型心肌梗死预后的影响  

Clinical Observation of Optimal Time Window for Elective PCI in STEMI Patients

作　　者：纪彩虹 高雯[2] 张宁[2] JI Caihong;GAO Wen;ZHANG Ning(Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040 China;Bayannaoer Hospital,Bayannaoer 015000 China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014040 [2]内蒙古巴彦淖尔市医院,内蒙古包头015000

出　　处：《内蒙古医学杂志》2024年第8期922-926,930,共6页Inner Mongolia Medical Journal

基　　金：巴彦淖尔市医院院内科研项目(编号:2022005)。

摘　　要：目的研究不同时间窗行经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)患者的预后,探讨是否有最佳PCI的时间窗。方法回顾性分析2018年12月至2021年12月巴彦淖尔市医院收治的诊断为STEMI并且诊治时间>3 d的患者113例。根据患者发病至行PCI治疗的时间分为两组,早期组(发病3~14 d内实施PCI治疗)65例、晚期组(发病15~28 d内实施PCI治疗)48例,收集并记录两组患者一般资料、介入治疗情况、入院后超声心动图数据,包括左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)、左室射血分数(left ventricular ejection fraction,LVEF)、左室短轴缩短率(left ventricular fractional shortening,LVFs)等及住院期间心血管不良事件(major adverse cardiovascular events,MACE),主要包括心绞痛、心力衰竭、心律失常、全因死亡等发生情况。通过门诊、电话等方式随访,收集并记录两组患者术后第1个月、12个月的超声心动图数据及12个月内MACE发生情况。分析不同时间窗行PCI对患者预后的影响。结果两组资料对比分析显示,与晚期组相比,早期组住院时间短、靶血管完全闭塞及单根血管病变例数少、术后12个月心功能均较前明显改善、12个月内MACE事件发生少,差异均有统计学意义(P<0.05)。结论错过最佳再灌注时间窗的STMEI患者,于3~14 d内行PCI预后好,可有效改善左室重构,减少MACE事件的发生,提高生活质量并缩短住院时间,降低院内感染等风险。Objective To investigate the optimal time window for elective PCI in STEMI patients.Methods A total of 113 patients diagnosed with STEMI and treated for longer than 3 days in Bayannur City Hospital from December 2018 to December 2021 were retrospectively analyzed.Patients were divided into two groups according to the time of onset to PCI treatment:There were 65 cases in the early group(PCI treatment within 3-14 days of onset)and 48 cases in the late group(PCI treatment within 15-28 days of onset).Collect and record,interventional treatment,two groups of patients with general data after admission echocardiographic data,including the final Left Ventricular diastolic Diameter(Left Ventricular End-diastolic Diameter,LVEDD,Left ventricular end systolic diameter,LVESD),Left Ventricular Ejection Fraction(Left Ventricular Ejection Fraction,LVEF),(Left Ventricular Fractional Shortening,LVFS),etc.and Major Adverse Cardiovascular Events(Major Adverse Cardiovascular Events,LVFS)during hospitalization.MACE.mainly including angina,heart failure,arrhythmia,all-cause death,etc.The echocardiogram data of 1 month and 12 months after surgery and the occurrence of MACE within 12 months were collected and recorded in the 2 groups through outpatient follow-up and telephone follow-up.To analyze the effect of elective PCI on the prognosis of patients with different time Windows.Results Comparative analysis of data between the two groups showed that compared with the late group,the early group had shorter hospital stay,less number of target vessel occlusion and single vessel lesions,significantly improved cardiac function 12 months after surgery,and fewer MACE events within 12 months,with statistical significance(P<0.05).Conclusion STMEI patients who miss the optimal reperfusion time window have a good prognosis after PCI within 3-14 days,which can effectively improve left ventricular remodeling,reduce the occurrence of MACE events,improve the quality of life,reduce the length of hospital stay,and avoid uncontrollable factors such as hos

关 键 词：STEMI 择期PCI 不同时间窗 预后 

分 类 号：R541[医药卫生—心血管疾病]