优化氧疗策略在伴低氧血症的急性心肌梗死患者经皮冠状动脉介入治疗后的应用评价
Evaluation of Optimized Oxygen Therapy Strategy after Percutaneous Coro-nary Intervention in Acute Myocardial Infarction Patients with Hypoxemia
黄嘉熙 1梁颖聪 1程贵粉 1詹晓燕1
作者信息
- 1. 南方医科大学附属广东省人民医院(广东省医学科学院)心内监护室,广州 510080
- 折叠
摘要
目的 探讨优化氧化策略在伴低氧血症的急性心肌梗死(acute myocardial infarction,AMI)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后的应用效果.方法 选取2020年3月至2021 年12月在广东省人民医院接受治疗的伴有低氧血症的AMI患者600例.按照入院 24h内最低血氧饱和度(arterial oxygen saturation,SaO2)是否≥95%或吸氧后动脉血气分析氧分压是否≥75 mmHg(1 mmHg=0.133 kPa)分成高血氧目标组(n=200)及低血氧目标组(n=100).结果 高血氧目标组患者的监护室住院时间短于低血氧目标组,差异有统计学意义(t=27.838,P<0.01);高血氧目标组患者住院期间新发的AMI并发症发生率为18.00%,低于低血氧目标组的35.00%,差异有统计学意义(χ2=10.665,P<0.01).高血氧目标组患者全因病死率为3.0%、心脑血管事件发生率为5.00%,均低于低血氧目标组,但差异无统计学意义(P>0.05).高血氧目标组患者的左心室射血分数(left ventricular ejection fraction,LVEF)高于低血氧目标组,差异有统计学意义(t=-6.285,P<0.01).高血氧目标组患者入院48 h、72 h血清氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、可溶性生长刺激表达基因 2 蛋白(soluble growth stimulation expressed gene 2,sST2)、肌酸激酶同工酶(creatine kinase isoenzymes,CK-MB)浓度均低于低血氧目标组,差异有统计学意义(P<0.05).结论 优化氧疗策略有助于改善伴低氧血症的AMI患者PCI治疗后的预后.
Abstract
Objectives To explore the effect of optimized oxidation strategy after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)with hypoxemia.Methods A total of 600 AMI patients with hypoxemia who were treated from March 2020 to December 2021 in Guangdong Provincial People's Hospital were selected.According to whether the lowest arterial oxygen saturation(SaO2)≥95%within 24 hours after admission or whether the arterial blood gas analysis oxygen partial pressure≥75 mmHg(1 mmHg=0.133 kPa),they were divided into hyperoxia target group(n=200)and hypooxia target group(n=100).Results The hospitalization duration in intensive care unite(ICU)of hyperoxia target group was shorter than that of hypooxia target group(t=27.838,P<0.01).The incidence of new AMI complications in hyperoxia target group during hospitalization was 18.00%,lower than 35.00%in hypooxia target group,and the difference was statistically significant(χ2=10.665,P<0.01).The all-cause mortality rate of hyper-oxia target group was 3.0%,and the incidence of cardiovascular and cerebrovascular events was 5.00%,which were lower than those of hypooxia target group,but the differences were not statistically significant(P>0.05).Left ventricular ejection fraction(LVEF)in hyperoxia target group was higher than that in hypooxia target group(t=-6.285,P<0.01).The serum concentrations of N-terminal pro-brain natriuretic peptide(NT-proBNP),soluble growth stimulation expressed gene 2(sST2)and creatine kinase isoenzymes(CK-MB)in hyperoxia target group were significantly lower than those in hypooxia target group at 48 h and 72 h after admission(P<0.05).Conclusions Optimizing oxygen therapy strategy is helpful to improve the prognosis of AMI patients with hypoxemia after PCI.
关键词
心肌梗死/优化氧疗策略/低氧血症/心脏重症监护Key words
myocardial infarction/optimize oxygen therapy strategy/hypoxemia/cardiac intensive care引用本文复制引用
基金项目
广东省医学科学技术研究项目(2019118181124134)
出版年
2024
NETL
NSTL
维普
万方数据