急性非ST段抬高型心肌梗死早期介入治疗和早期保守治疗预后对比研究

【摘要】 目的：探讨急性非ST段抬高型心肌梗死早期介入治疗和早期保守治疗疗效及预后。方法：选取2010年3月至2015年2月在我院心内科住院诊断为急性非ST段抬高型心肌梗死患者160例为研究对象,根据早期治疗策略不同分为早期介入治疗组80例(实验组)和早期保守治疗组80例(对照组)。实验组立即行冠状动脉造影检查,依据造影结果进一步予以经皮冠状动脉介入治疗(PCI),对照组予以保守治疗一周后行PCI治疗。随访6个月,比较两组患者治疗前后左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)和左心室射血分数(LVEF)指标的变化以及住院和随访期间主要不良事件发生率。结果：术后一周实验组和对照组LVEDV、LVESV和LVEF三项指标差异无统计学意义(P＞0.05)；与术后一周相比,术后6个月实验组与对照组LVEDV、LVESV明显降低,LVEF明显升高(P＜0.05)；术后6个月实验组LVEDV、LVESV明显低于对照组,LVEF明显高于对照组(P＜0.05)。实验组住院期间心绞痛发生率、恶性心律失常发生率、梗死复发再次住院率和随访期间心源性死亡率均低于对照组(P＜0.05)。结论：早期介入治疗和早期保守治疗均可改善急性非ST段抬高型心肌梗死患者心功能,早期介入治疗疗效更显著,且降低了患者住院和随访期间主要不良事件发生率,值得在临床上推广。

Comparison of early invasive therapy and early conservative therapy in patients with acute non-ST-segment elevation myocardial infarction

Objective To investigate the acute non-ST segment elevation myocardial infarction (NSTEMI) early invasive therapy and early conservative therapy and prognosis. Methods 160 patients with NSTEMI during March 2010 to February 2015 in our hospital were divided into two groups,early invasive therapy group(experimentalgroup) 80 cases and early conservative therapy group(controlgroup) 80 cases.The experimental group immediatelySunderwent coronary angiography,according to the angiographic results could be further percutaneous coronary intervention(PCI).The control group to be treated with PCI underwent conservative therapy one week.Follow-up of six months,the two groups were compared before and after treatment left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF) and the main indicators of change in the incidence of major adverse cardiovascular events during hospitalization and during follow-up. Results Postoperative week and after six months in the experimental group the LVEDV and LVESV were significantly lower than the control group,LVEF was significantly higher(P<0.05).The incidence of angina, malignant arrhythmias during hospitalization,recurrent infarction hospitalization rates again,six months endogenous heart mortality was lower in experimental group than control group (P<0.05). Conclusion The early invasive therapy and early conservative therapy can both improve the cardiac function of patients with NSTEMI.The effect of early invasive therapy is more significant compared with early conservative therapy,and early invasive therapy can reduce the incidence of major adverse cardiovascular events during hospitalization and during follow-up.so the early invasive therapy is worthySofSclinicalSapplication.