直接经皮冠状动脉介入治疗对高龄急性心肌梗死患者心室重构与心功能的影响

目的评估直接经皮冠状动脉介入治疗(PCI)对高龄急性心肌梗死(AMI)患者心室重构及心功能的影响。方法选取2017年5月至2019年5月我科收治的高龄AMI患者100例,分为研究组和对照组,每组患者各50例,其中研究组接受直接PCI治疗+标准药物治疗,对照组给予标准的药物治疗,比较治疗前后两组的可溶性ST2(sST2)和N-末端脑钠肽前体(NT-proBNP)水平及超声心动图结果。结果治疗后两组的sST2、NT-proBNP水平均有所下降,且研究组下降幅度优于对照组(P<0.05);治疗后两组左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、球形指数(SI)、室间隔厚度(IVST)及左室后壁厚度(LVPWT)均下降,而左室射血分数(LVEF)均升高,且研究组效果优于对照组(P<0.05)。结论直接PCI可有效挽救高龄AMI患者的梗死心肌,能有效延缓高龄AMI患者的心室重构,改善心功能,是高龄AMI患者的有效且安全的治疗手段。

Effects of direct PCI on ventricular remodeling and cardiac function in elderly patients with AMI

Objective To evaluate the effects of direct percutaneous coronary intervention(PCI)on ventricular remodeling and cardiac function in elderly patients with acute myocardial infarction(AMI).Methods A total number of 100 elderly patients with AMI in the department of cardiology of First Affiliated Hospital of Hebei North University from May 2017 to May 2019 were enrolled in this study,and were divided into experimental group and control group,each group had 50 cases,the experimental group received direct PCI treatment and standardized treatment of drugs,control group received the standard treatment of drugs.The concentrations of soluble ST2(sST2)and N-terminal brain natriuretic peptide precursor(NT-proBNP)were assessed and compared,the echocardiographic results were also compared in the two groups.Results sST2 and NT-proBNP of two groups after treatment declined,and the decline of the experimental group was better than the control group(P<0.05).The left ventricular end-diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),spherical index(SI),interventricular septum thickness(IVST)and left ventricular posterior wall thickness(LVPWT)of two groups all decreased,while the left ventricular ejection fraction(LVEF)all increased,and the effect of the experimental group was better than the control group(P<0.05).Conclusion Direct PCI can effectively save the infarcted myocardium in elderly patients with AMI,also can effectively delay ventricular remodeling and improve cardiac function in elderly patients with AMI,PCI is an effective and safe treatment for elderly patients with AMI.