摘要
目的探讨经皮冠状动脉介入治疗对急性心肌梗死后左心室重构、氧化应激反应及心功能的影响。方法选择2016年1~6月在我院心内科收治的169例急性心肌梗死患者,其中行经皮冠状动脉介入治疗85例(介入组)与静脉溶栓治疗84例(对照组)。观察2组在治疗后半个月及6个月肌钙蛋白Ⅰ(cTnⅠ)、N末端B型钠尿肽前体(NT-proBNP)、谷胱甘肽过氧化物酶(GSH)、超氧化物歧化酶(SOD)、LVEF及症状体征等改善情况。结果治疗后6个月,介入组NT-proBNP、LVEF、症状体征改善评分优于对照组[(227.2±52.5)ng/L vs(443.3±59.2)ng/L、(44.7±6.2)%vs(38.2±5.3)%、(5.7±1.4)分vs(10.4±2.7)分,P=0.000]。治疗后半个月,介入组cTnⅠ水平显著低于对照组[(1.15±0.29)μg/L vs(2.41±0.36)μg/L,P=0.000],2组SOD、GSH比较无显著差异(P>0.05)。治疗后6个月,2组SOD、GSH均明显升高,差异有统计学意义(P=0.000)。介入组的半年再住院率为23.53%,总体有效率为94.12%,对照组再住院率高达46.43%,总体有效率仅为71.43%,2组比较有显著差异(P<0.05)。结论急性心肌梗死早期接受经皮冠状动脉介入治疗,有利于降低体内氧化应激反应,逆转左心室重构,有利于心功能的恢复,提高患者的预后情况,减少再住院率。
Objective To study the effect of PCI on left ventricular remodeling,oxidative stress and cardiac function after acute myocardial infarction（AMI）.Methods One hundred and sixty-nine AMI patients were divided into PCI group（n=85）and control group（n=84）.Their serum cTnⅠ,NT-proBNP,GSH,SOD levels and LVEF were measured,and their symptom and sign scores were recorded after 15 days and 6 months of PCI.Results The serum NT-proBNP level was significantly lower while the LVEF and symptom and sign scores were significantly higher in PCI group than in control group after 6 months of PCI（227.2±52.5 ng/L vs 443.3±59.2 ng/L,44.7%±6.2%vs 38.2%±5.3%,5.7±1.4 vs 10.4±2.7,P=0.000）.The serum cTnⅠ level was significantly lower in PCI group than in control group after 15 days of PCI（1.15±0.29μg/Lvs 2.41±0.36μg/L,P=0.000）.No significant difference was found in SOD and GSH between the two groups（P0.05）.The readmission rate was 23.53% and the total effective rate was 94.12%in PCI group while the readmission rate was 46.43%and the total effective rate was 71.43%in control group after 6 months of PCI（P0.05）.Conclusion PCI can reduce the oxidative stress,reverse the left ventricular remodeling,improve the outcome and reduce the readmission rate in early AMI patients.
作者
张文广
马立永
陈金岭
Zhang Wenguang, Ma Liyong, Chen Jinling(Department of Cardiology ,Beijing Pinggu District Hospital ,Beijing 101200 ,Chin)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2018年第3期253-256,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
