Observation of effect of transradial emergency PCI and early PCI after thrombolysis on cardiac function in patients with ST-segment elevation acute myocardial infarction
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摘要: 目的 探讨经桡动脉对ST段抬高型急性心肌梗死(STEMI)患者急诊冠状动脉介入(PPCI)治疗与静脉溶栓后早期PCI对患者心功能的影响及早期PCI应用价值。 方法 选择2016年1月—2017年1月蚌埠医学院第一附属医院先后入院的92例STEMI患者分为:急诊PCI组76例(入院后立即给予急诊介入治疗),静脉溶栓后行早期PCI组16例(静脉溶栓后行早期PCI)。分析2组患者临床疗效,患者左心室舒张末期容积(LVEDV)和左室射血分数(LVEF),患者复合心血管事件的发生率。 结果 2组患者的基线结果无显著差异,溶栓后早期介入组患者冠状动脉血流TIMI 3级明显高于急诊介入组(93.7% vs. 78.9%,P<0.05);术后随访12个月,2组患者心脏超声检测左室舒张末期容积(102.2±15.3 vs. 97.6±21.5)、左室射血分数[(43.6±7.8)% vs. (46.5±5.7)%]比较差异均无统计学意义(均P>0.05),复合心血管事件(6.6% vs. 6.3%)差异无统计学意义(P>0.05)。 结论 对于首诊于无急诊介入条件基层医院的STEMI患者,溶栓后及时转运至上级医院早期行PCI安全有效。不影响患者心功能恢复,同时未增加患者复合心血管事件发生率。
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关键词:
- 经桡动脉 /
- 急诊经皮冠状动脉介入术 /
- 急性ST段抬高型心肌梗死 /
- 阿替普酶
Abstract: Objective To explore the effect of transradial percutaneous coronary intervention (PCI) and early PCI after intravenous thrombolysis on cardiac function in patients with ST-segment elevation of acute myocardial infarction (STEMI) and the application value of early PCI. Methods Ninety-two patients were admitted successively From January 2016 to January 2017,in the First Affiliated Hospital of Bengbu Medical College.they were divided into emergency PCI group (76 cases) and early PCI group (16 cases) after intravenous thrombolysis. The clinical efficacy, the left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF), and the incidence of compound cardiovascular events of the two groups were analyzed. Results There was no significant difference in baseline results between the two groups. The TIMI 3 level of coronary artery blood flow in the early PCI group was significantly higher than that in the emergency PCI group (93.7% vs. 78.9%, P<0.05). After 12 months of follow-up, there was no significant difference in LVEDI (102.2±15.3 vs. 97.6±21.5), LVEF [(43.6±7.8)% vs. (46.5±5.7)%] and compound cardiovascular events (6.6% vs. 6.3%) between the two groups (all P>0.05). Conclusion For STEMI patients who were diagnosed in primary hospitals without emergency intervention conditions, it is safe and effective to transport them to superior hospitals in time for PCI in early stage after thrombolysis. It does not affect the recovery of cardiac function and do not increase the occurrence of compound cardiovascular events.
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