摘要
目的探讨急诊和择期经皮冠状动脉介入(PCI)术后心肌的修复情况。方法回顾性分析2018年1月至2019年2月广安市人民医院心血管内科住院的心肌梗死患者97例,根据行PCI术时机分为急诊PCI术组50例和择期PCI术组47例,术后3个月通过心脏磁共振成像(CMRI)评估和比较2组患者心功能和心肌修复情况,并比较术前和术后3个月肌钙蛋白I(TnI)、脑钠肽(BNP)和肌酸激酶同工酶MB(CK-MB)水平。应用SPSS 19.0统计软件对数据进行分析,根据数据类型采用t检验或χ2检验进行组间比较。相关性采用Pearson相关分析。结果2组患者PCI术后3个月较术前左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、梗死心肌质量、梗死心肌容积视觉评分、室壁运动异常评分、TnI、BNP和CK-MB均改善,且急诊PCI术组相比择期PCI术组患者水平低[(108.41±21.15)和(126.61±22.05)ml;(59.55±14.41)和(65.54±11.64)ml;(6.84±2.15)和(9.16±3.00)g;(6.03±2.11)和(8.15±2.32)分;(3.01±1.16)和(4.41±1.25)分;(106.84±29.98)和(122.16±32.11)g/L;(1.00±0.34)和(1.24±0.54)ng/L;(32.21±5.44)和(35.49±4.48)U/L],差异均有统计学意义(P<0.05)。Pearson相关分析结果表明,梗死心肌质量与梗死心肌容积视觉评分、室壁运动异常评分、LVEDV、LVESV正相关(r=0.411、0.354、0.306和0.341,P<0.05)。结论急诊PCI术可显著改善心肌梗死患者心肌的功能和修复。
Objective To investigate the myocardial repair after emergency and elective percutaneous coronary intervention(PCI).Methods A retrospective study was conducted on 97 patients with myocardial infarction admitted in our department from January 2018 to February 2019.According to the timing of PCI,they were divided into emergency PCI group(n=50)and selective PCI group(n=47).Cardiac function and myocardial repair were evaluated and compared by cardiac magnetic resonance imaging(CMRI)in 3 months after operation.The levels of troponin I(TnI),brain natriuretic peptide(BNP)and creatine kinase isoenzyme-MB(CK-MB)were compared before and 3 months after operation.SPSS statistics 22.0 was used for data analysis.Student′s t test or Chi-square test was applied to make comparison between 2 groups according to the different data types.Pearson correlation analysis was also employed.Results Compared with before operation,left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),preoperative myocardial mass,visual score of myocardial volume,abnormal wall motion score,and levels of TnI,BNP and CK-MB were all improved in both groups,and the indicators were lower in the emergency PCI group than the selective PCI group[(108.41±21.15)vs(126.61±22.05)ml,(59.55±14.41 vs(65.54±11.64)ml,(6.84±2.15)vs(9.16±3.00)g,(6.03±2.11)vs(8.15±2.32)score,(3.01±1.16)vs(4.41±1.25)score,(106.84±29.98)vs(122.16±32.11)g/L,(1.00±0.34)vs(1.24±0.54)ng/L,(32.21±5.44)vs(35.49±4.48)U/L].Pearson correlation analysis showed that myocardial quality was positively correlated with myocardial volume visual score,wall motion abnormality score,LVEDV and LVESV(r=0.411,0.354,0.306 and 0.341,P<0.05).Conclusion Emergency PCI can significantly improve myocardial function and repair in patients with myocardial infarction.
作者
李宇林
顾永林
庹田
文俊杰
彭军
刘丁铭
LI Yu-Lin;GU Yong-Lin;TUO Tian;WEN Jun-Jie;PENG Jun;LIU Ding-Ming(Department of Cardiology,Guang′an People′s Hospital,Guang′an 6385000,China)
出处
《中华老年多器官疾病杂志》
2019年第11期855-859,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
四川省医学科研青年创新课题(Q17035)~~
关键词
磁共振成像
经皮冠状动脉介入
急诊
择期
magnetic resonance imaging
percutaneous coronary intervention
emergency
selection
