摘要
目的探讨经皮冠状动脉介入治疗(PCI)急性心肌梗死(AMI)术中应用地尔硫卓对患者早期心功能的影响。方法选择我院2018年1月~12月拟行PCI的AMI患者107例,随机分为对照组54例和实验组53例。对照组术中带孔球囊通过罪犯血管后在病变远端推注8 ml生理盐水,实验组则推注8 ml地尔硫卓,随访半年,比较两组术后24 h肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(CTnⅠ)、氨基末端脑钠肽前体(NT-proBNP)、PCI术后TIMI血流分级、TIMI心肌灌注(TMP)分级、PCI术后1周及6个月内左心射血分数(EF)、左室缩短率(FS)及左室舒张末期内径(LVEDD)及主要心血管不良事件(MACE)。结果PCI术后实验组TIMI血流分级及TMP分级均优于对照组,差异具有统计学意义(P<0.05);术后24 h两组CK-MB、CTnⅠ、NT-proBNP均较治疗前改善,且实验组CK-MB、CTnI、NT-proBNP优于对照组,差异具有统计学意义(P<0.05);术后1周实验组EF、FS、LVEDD均优于对照组,术后6个月实验组EF、FS及LVEDD分别为(58.32±7.10)%、(37.09±5.56)%、LVEDD(47.39±4.46)mm,优于对照组的(42.05±5.67)%、(29.03±9.51)%、(48.81±6.16)mm,差异有统计学意义(P<0.05);术后6个月实验组MACE发生率低于对照组,差异有统计学意义(P<0.05)。结论AMI患者PCI术中应用地尔硫卓能提高患者的TIMI血流分级、TMP分级,改善患者心肌功能,且安全性高,值得应用。
Objective To investigate the effect of diltiazem on early cardiac function in patients with acute myocardial infarction(AMI)percutaneous coronary intervention(PCI).Methods A total of 107 patients with AMI who planned to undergo PCI in our hospital from January to December 2018 were randomly divided into 54 cases in the control group and 53 cases in the experimental group.In the control group,8 ml of saline was injected into the distal end of the lesion after the perforated balloon passed through the criminal's blood vessel.In the experimental group,8 ml of diltiazem was injected.Half a year after follow-up,the two groups were compared with 24 h postoperative myokinase isoenzyme(CK-MB),Troponin I(CTnⅠ),amino terminal brain natriuretic peptide precursor(NT-proBNP),TIMI blood flow classification after PCI,TIMI myocardial perfusion(TMP)classification,left ventricular ejection within 1 week and 6 months Blood fraction(EF),left ventricular shortening rate(FS),left ventricular end-diastolic diameter(LVEDD),and major cardiovascular adverse events(MACE).Results The TIMI blood flow classification and TMP classification of the experimental group after PCI were better than those of the control group,the differences were statistically significant(P<0.05).CK-MB,CTnⅠ,NT-proBNP in both groups were improved compared with those before treatment at 24 h after operation,and CK-MB,CTnI,NT-proBNP in the experimental group were better than those in the control group,the differences were statistically significant(P<0.05);The EF,FS,and LVEDD of the experimental group were better than the control group at 1 week after operation.The EF,FS,and LVEDD of the experimental group at 6 months after operation were(58.32±7.10)%,(37.09±5.56)%,and LVEDD(47.39±4.46)mm,better than(42.05±5.67)%,(29.03±9.51)%,and(48.81±6.16)mm of the control group,the difference was statistically significant(P<0.05);the incidence of MACE in the experimental group 6 months after compared with the control group,the difference was statistically significant(P<0.05)
作者
彭志祥
张宜春
顾崇怀
乔锐
张省
PENG Zhi-xiang;ZHANG Yi-chun;GU Chong-huai;QIAO Rui;ZHANG Sheng(Department of Cardiology,Anqing Hospital,Anhui Medical University,Anqing 246000,Anhui,China)
出处
《医学信息》
2020年第1期146-148,共3页
Journal of Medical Information
基金
安庆市科技局项目(编号：2018Z2014)
关键词
急性心肌梗死
地尔硫卓
冠状动脉介入
心功能
Acute myocardial infarction
Diltiazem
Coronary intervention
Cardiac function
