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目的探讨前壁心肌梗死患者实施急诊冠状动脉介入治疗中重组人脑利钠肽对其左室功能的影响。方法 72例实施急诊冠状动脉介入治疗的前壁心肌梗死患者随机分为研究组(36例,采用重组人脑利钠肽治疗)与对照组(36例,采用常规药物治疗),对比两组治疗效果。结果治疗后,研究组左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心房内径(LAD)分别为(50.4±15.4)%、(45.2±12.0)mm、(35.1±9.2)mm,对照组分别为(42.3±12.5)%、(53.6±14.3)mm、(37.5±9.5)mm,两组LVEF、LVEDD比较,差异具有统计学意义(P<0.05),但两组LAD比较,差异无统计学意义(P>0.05)。治疗后,研究组白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、可溶性细胞间黏附分子-1(s ICAM-1)、可溶性血管细胞黏附分子-1(s VCAM-1)分别为(24.1±4.1)ng/L、(6.8±3.1)mg/L、(22.5±3.1)ng/ml、(22.6±3.6)ng/L,对照组分别为(32.4±2.5)ng/L、(10.5±3.2)mg/L、(31.8±2.6)ng/ml、(32.9±2.5)ng/L,两组上述指标比较,差异具有统计学意义(P<0.05)。研究组1例急性左心衰竭,不良心脏事件发生率为2.8%;对照组发生3例急性左心衰竭,2例梗死后心绞痛,1例原位再梗死,不良心脏事件发生率为16.7%;两组不良心脏事件发生率比较,差异具有统计学意义(P<0.05)。结论在前壁心肌梗死患者实施急诊冠状动脉介入治疗过程中,实施重组人脑利钠肽治疗的效果显著,能对患者左室功能进行改善,值得推广应用。
Objective To investigate the effect of recombinant human brain natriuretic peptide on left ventricular function in patients with anterior myocardial infarction undergoing emergency coronary intervention. Methods Seventy-two patients with anterior myocardial infarction undergoing emergency PCI were randomly divided into study group (36 patients treated with recombinant human brain natriuretic peptide) and control group (36 patients treated with conventional drugs), compared with two groups effect. Results After treatment, LVEF, LVEDD and LAD were (50.4 ± 15.4)%, (45.2 ± 12.0) mm, (35.1 ± 9.2) ) in the control group were (42.3 ± 12.5)%, (53.6 ± 14.3) mm and (37.5 ± 9.5) mm, respectively. There was significant difference between the two groups in LVEF and LVEDD (P <0.05) The difference was not statistically significant (P> 0.05). After treatment, the levels of interleukin-6, hs-CRP, s ICAM-1, sVCAM-1 VCAM-1 were (24.1 ± 4.1) ng / L and (6.8 ± 3.1) mg / L and (22.5 ± 3.1) ng / (10.5 ± 3.2) mg / L, (31.8 ± 2.6) ng / ml and (32.9 ± 2.5) ng / L, respectively. There were significant differences between the two groups in the above indexes (P <0.05). The study group had 1 case of acute left heart failure and 2.8% of adverse cardiac events. The control group had 3 cases of acute left heart failure, 2 cases of post - infarction angina and 1 case of reinfarction. The incidence of adverse cardiac events was 16.7%. The incidence of adverse cardiac events between the two groups, the difference was statistically significant (P <0.05). Conclusions The effect of recombinant human brain natriuretic peptide in the treatment of patients with anterior myocardial infarction during emergency coronary intervention is significant and can improve left ventricular function in patients with myocardial infarction.