摘要
目的探讨球囊缓慢撤压对急性ST段抬高型心肌梗死(STEMI)介入治疗患者临床疗效。方法选取郑州市第七人民医院2020年1月至2022年7月收入的158例STEMI患者,根据治疗方式不同,将常规方式撤压患者纳入对照组(N=83),采用球囊缓慢撤压患者纳入观察组(N=75)。比较两组治疗后1 h即刻抬高ST段回落≥50%占比差异、治疗前及治疗后冠状动脉血流指标[心肌梗死溶栓治疗后(TIMI)血流分级、校正的TIMI血流帧数(CTFC)]、心功能[左心室射血分数(LVEF)、心指数(CI)]、治疗后24 h两组患者实验室检查指标[心肌肌钙蛋白I(cTnI)、内皮素1(ET-1)、N末端B型利钠肽(NT-proBNP)]水平变化,比较两组治疗中慢血流、无复流发生率。结果观察组治疗后TIMI、心功能、即刻抬高ST段回落≥50%占比、大于对照组,差异有统计学意义(P<0.05)。治疗后CTFC、24 h内cTnI、ET-1、NT-proBNP以及慢血流、无复流发生率小于对照组,差异有统计学意义(P<0.05)。结论STEMI介入治疗患者应用球囊缓慢撤压可有效改善血流灌注及心功能,预防慢血流、无复流发生,加快预后转归。
Objective To investigate the clinical efficacy of slow balloon decompression in patients with acute ST segment elevation myocardial infarction(STEMI)undergoing interventional therapy.Methods A total of 158 patients with STEMI admitted to the Seventh People Hospital of Zhengzhou from January 2020 to July 2022 were selected.According to the different treatment methods,the patients with routine method of pressure withdrawal were included in the control group(N=83),and the patients with slow balloon method of pressure withdrawal were included in the observation group(N=75).The difference between the two groups in the proportion of ST-segment immediate elevation≥50%at 1 h after treatment,coronary artery blood flow index[TIMI blood flow grade after thrombolytic therapy for myocardial infarction,corrected TIMI blood flow frame number(CTFC)],cardiac function[left ventricular ejection fraction(LVEF),cardiac index number(CI)],and the changes in the levels of patients’laboratory examination indexes after 24 hours treatment[cardiac troponin I(cTnI),endothelin-1(ET-1),N-terminal B-type natriuretic peptide(NT-proBNP)]before and after treatment were compared,the incidence of slow flow and no reflow was compared between the two groups.Results After treatment,TIMI,cardiac function,the proportion of ST-segment immediate elevation≥50%in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the incidence of CTFC,cTnI,ET-1,NT-proBNP,slow blood flow and no reflow within 24 hours were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of slow balloon decompression in STEMI patients can effectively improve blood perfusion and cardiac function,prevent slow blood flow and no reflow,and accelerate the prognosis.
作者
杨晓航
董加建
岳凤阳
毛幼林
YANG Xiaohang;DONG Jiajian;YUE Fengyang;MAO Youlin(Department of Cardiology,Zhengzhou Seventh People's Hospital,Zhengzhou Henan 450016,China)
出处
《临床研究》
2022年第11期100-103,共4页
Clinical Research
基金
药物球囊扩张时间对冠心病接受介入治疗患者预后的影响(LHGJ20210751)。
关键词
球囊缓慢撤压
急性ST段抬高型心肌梗死
慢血流
无复流
slow balloon decompression
acute ST-segment elevation myocardial infarction
slow blood flow
no reflow
