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目的评价急诊经皮冠状动脉介入治疗(PCI)术联合应用凯时(前列腺素E1)对术后心肌灌注的影响。方法将58例接受急诊PCI治疗且符合术前梗死相关血管完全闭塞(血流TIMI0级或1级),PCI治疗后梗死相关血管达到血流TIMI3级的急性心肌梗死患者随机分为凯时组28例和对照组30例。比较两组临床特征、心肌呈色分级(MBG)、心电图ST段回落指数(sumSTR)及住院期间主要心血管事件、左室射血分数。结果两组基础临床情况及造影特征无明显差异。凯时组心肌呈色分级2/3级获得率明显增高(71.4%vs43.3%,P<0.05),术后心电图ST段回落指数(sumSTR)≥50%的比例更高(82.1%vs53.3%,P<0.05)。心肌梗死1周后射血分数亦高于对照组(57.3%±5.4%vs47.2%±7.2%,P<0.05)。两组住院期间主要心血管事件差异无统计学意义(P>0.05)。结论急性心肌梗死患者在急诊PCI基础上,联合凯时治疗可改善心肌灌注,改善患者心功能,近期疗效好,无不良反应。
Objective To evaluate the effect of percutaneous coronary intervention (PCI) on myocardial perfusion after combined use of Kay (prostaglandin E1). Methods Fifty-eight patients with acute myocardial infarction who underwent emergency PCI and were eligible for preoperative infarction-related vascular occlusion (TIMI grade 0 or grade 1) and infarct-related blood vessels to TIMI grade 3 after PCI were randomly assigned to Kai Shi 28 Cases and control group of 30 cases. The clinical features, MBG, sumSTR of ECG ST-segment, and major cardiovascular events during hospitalization and left ventricular ejection fraction were compared. Results There was no significant difference between the two groups in basic clinical conditions and imaging features. The rate of myocardial grade 2/3 was significantly higher in the Kai group (71.4% vs43.3%, P <0.05), and the percentage of patients with an ST-segment STS≥50% was significantly higher in the Kai group (82.1% vs53; 3%, P <0.05). One week after myocardial infarction, the ejection fraction was also higher than that of the control group (57.3% ± 5.4% vs 47.2% ± 7.2%, P <0.05). There were no significant differences in major cardiovascular events between the two groups during hospitalization (P> 0.05). Conclusions Patients with acute myocardial infarction can improve myocardial perfusion and improve cardiac function in patients with acute myocardial infarction, based on emergency PCI, combined with Kai time treatment, with good short-term efficacy and no adverse reactions.