目的 探究急诊经皮冠状动脉介入(PCI)联合抽吸导管对急性ST段抬高型心肌梗死(STEMI)伴心力衰竭(HF)患者预后及心室重构的影响。方法 以2019年10月-2022年10月修水县第一人民医院收治的100例STEMI伴HF患者为研究对象，经随机数字表法分为对照组与观察组，各50例。对照组直接行急诊PCI治疗，观察组则采用PCI联合抽吸导管治疗，比较两组术后疗效(TIMI血流分级、术后2hST段回落率)、心肌损伤指标[肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTn Ⅰ)]、心室重构指标[左室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室质量(LVM)]、术后3个月主要心血管事件(MACE)。结果 观察组术后TIMI血流分级、术后2 h ST段回落率均高于对照组(P＜0。05);两组术后CK-MB、cTn Ⅰ低于术前，且观察组低于对照组(P＜0。05);两组术后LVPWT、IVST小于术前，LVMI大于术前，且观察组LVPWT、IVST小于对照组，LVMI大于对照组(P＜0。05);两组术后3个月MACE发生率比较，差异无统计学意义(P＞0。05)。结论 急诊PCI联合血栓抽吸导管在STEMI伴HF治疗中具有确切疗效，可进一步改善心肌血流灌注与ST段回落幅度，减轻患者心肌损伤，抑制心室重构，且不增加术后MACE风险。
Effect of Emergency Intervention Combined with Aspiration Catheter on Prognosis and Ventricular Remodeling in Patients with Acute ST-segment Elevation Myocardial Infarction Complicated with Heart Failure
Objective To investigate the effect of emergency percutaneous coronary intervention(PCI)combined with aspiration catheter on prognosis and ventricular remodeling in patients with acute ST-segment elevation myocardial infarction(STEMI)complicated with heart failure(HF).Methods A total of 100 STEMI patients with HF admitted to Xiushui County First People's Hospital from October 2019 to October 2022 were divided into control group and observation group by random number table method,with 50 patients in each group.The control group was treated with emergency PCI directly,while the observation group was treated with PCI combined with aspiration catheter.The postoperative efficacy(TIMI blood flow grade,ST segment fall rate at 2 h after operation),myocardial injury indexes[creatine kinase isoenzyme(CK-MB),troponin Ⅰ(cTn Ⅰ)],ventricular remodeling indexes[left ventricular posterior wall thickness(LVPWT),interventricular septum thickness(IVST),left ventricular mass(LVM)]and major cardiovascular events(MACE)at 3 months after operation were compared between the two groups.Results The TIMI blood flow grade and ST segment resolution rate at 2 h after operation in the observation group were higher than those in the control group(P＜0.05).The levels of CK-MB and cTn Ⅰ in the two groups after operation were lower than those before operation,and those in the observation group were lower than those in the control group(P＜0.05).The LVPWT and IVST of the two groups after operation were lower than those before operation,and the LVMI was higher than that before operation,while the LVPWT and IVST of the observation group were lower than those of the control group,and the LVMI was higher than that of the control group(P＜0.05).There was no significant difference in the incidence of MACE between the two groups at 3 months after operation(P＞0.05).Conclusion Emergency PCI combined with aspiration catheter has a definite effect in the treatment of STEMI with HF,which can further improve myocardial perfusion and ST segment resolution,reduce myocardial injury,inhibit ventricular remodeling,and do not increase the risk of postoperative MACE.
万方数据
维普
