经皮冠状动脉介入治疗联合心脏临时起搏器植入术治疗急性心肌梗死并发缓慢性心律失常的效果  

Effect of percutaneous coronary intervention combined with temporary cardiac pacemaker implantation on chronic bradyarrhythmia in patients with acute myocardial infarction

作　　者：李坚 LI Jian(Department of Cardiology,Anning First People's Hospital,Kunming,Yunnan,650300,China)

机构地区：[1]安宁市第一人民医院心血管内科,云南昆明650300

出　　处：《当代医学》2024年第17期175-178,共4页Contemporary Medicine

摘　　要：目的探究经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)联合心脏临时起搏器植入术治疗急性心肌梗死(AMI)并发缓慢性心律失常的效果。方法选取2016年5月至2021年5月安宁市第一人民医院收治的62例AMI并发缓慢性心律失常患者作为研究对象,按照随机抽签法分为PCI组与联用组,每组31例。PCI组采用PCI术治疗,联用组采用PCI联合临时心脏起搏器治疗。比较两组心肌指标[左心室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)、B型钠尿肽(type B natriuretic peptide,BNP)、肌红蛋白(myoglobin,Mb)、心输出量(cardiac output,CO)、心肌肌钙蛋白I(cardiac troponin I,cTnI)]水平、生命质量评分及不良反应发生情况。结果联用组LVEDD、LVESD均短于PCI组,BNP、Mb、cTnI水平均低于PCI组,LVEF、CO水平均高于PCI组,差异有统计学意义(P<0.05)。治疗后,两组病情(illness state,IS)、体力(physical function,PF)、生活功能(life function,LF)、心理功能(mental function,SMF)、医疗情况(medicine function,MF)、工作情况(work function,WF)评分及总分均高于治疗前,且联用组高于PCI组,差异有统计学意义(P<0.05)。联用组不良反应发生率低于PCI组,差异有统计学意义(P<0.05)。结论PCI联合临时心脏起搏器治疗AMI并发缓慢性心律失常效果显著,能改善患者心肌指标水平,减少不良反应的发生,提高生命质量,值得临床推广应用。Objective To investigate the effect of percutaneous coronary intervention(PCI)combined with temporary cardiac pacemaker implantation in the treatment of acute myocardial infarction(AMI)with bradyarrhythmia.Methods 62 patients with AMI complicated with bradycardia and chronic arrhythmias from May 2016 to May 2021 in Anning First People's Hospital were selected as research subjects,and they were divided into the PCI group and the combined group acording to the random number table method,with 31 cases in each group.The PCI group was treated with PCI,and the combined group was treated with PCI and temporary cardiac pacemaker.Myocardial indexes(left ventricular end diastolic diameter[LVEDD],left ventricular end systolic diameter[LVESD],B-type natriuretic peptide[BNP],myoglobin[Mb],cardiac output[CO],cardiac troponin I[cTnI]),quality of life scores and adverse reactions were compared between the two groups.Results After treatment,the LVEDD and LVESD in the combined group were shorter than those in the PCI group,BNP,Mb and cTnI levels were lower than those in the PCI group,and LVEF and CO levels were higher than those in the PCI group,the differences were statistically significant(P<0.05).After treatment,the illness state(IS),physical function(PF),life function(LF),mental function(SMF),medicine function(MF),work function(WF)scores and total scores were higher than before treatment,and the combined group was higher than the PCI group,the differences were statistically significant(P<0.05).The adverse reaction rate in the combination group was lower than that in the PCI group,the difference was statistically significant(P<0.05).Conclusion PCI combined with temporary pacemaker is effective in the treatment of AMI complicated with chronic arrhythmia,which can improve the level of myocardial index,reduce adverse reactions,and improve the quality of life,it is worthy of clinical promotion and application.

关 键 词：经皮冠状动脉介入治疗 心脏临时起搏器植入术 急性心肌梗死 缓慢性心律失常 

分 类 号：R542.22[医药卫生—心血管疾病]