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目的探讨易化经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)与直接PCI对老年急性ST段抬高型心肌梗死术后左心室重构与心功能的影响。方法选择本院2012年6月—2016年6月收治的急性ST段抬高型心肌梗死123例,按照随机数字表法将所有患者随机分为试验组和对照组,试验组63例,对照组60例。试验组患者采用易化PCI治疗,对照组患者采用直接PCI治疗,比较两组患者左心室重构和心功能指标。计量资料两组间比较采用独立样本t检验,组内比较采用配对t检验;计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果治疗前后两组患者左室收缩末期容积指数(left ventricular end systolic volume index,LVESVI)[(33.14±9.86)、(30.41±8.03)ml/m~2与(33.65±10.23)、(29.25±7.28)ml/m~2]、左室舒张期末容积指数(left ventricular end diastolic volume index,LVEDVI)[(64.53±12.34)、(61.39±10.52)ml/m~2与(63.96±12.55)、(60.06±11.78)ml/m~2]、左室短轴缩短率(left ventricular shortening fraction,LVSF)[(27.87±5.63)%、(33.45±5.92)%与(27.11±5.38)%、(32.75±6.12)%]比较,差异均有统计学意义(均P<0.05)。治疗后1周两组患者左心室射血分数(left ventricular ejection fraction,LVEF)比较,差异有统计学意义(P<0.05)。治疗前后两组患者峰射血率(peak ejection rate,PER)[(1.31±0.08)、(1.65±0.11)EDV/s与(1.30±0.07)、(1.62±0.09)EDV/s]、峰充盈率(peak filling rate,PFR)[(1.39±0.13)、(1.92±0.22)EDV/s与(1.41±0.14)、(1.85±0.21)EDV/s]、LVEF[(39.85±4.02)%、(50.16±5.26)%与(39.15±4.18)%、(45.37±4.97)%]比较,差异均有统计学意义(均P<0.05)。结论对老年急性ST段抬高型心肌梗死患者行易化PCI可提高其左心射血功能,而在其它方面疗效相近。
Objective To investigate the effect of percutaneous coronary intervention (PCI) and direct PCI on left ventricular remodeling and cardiac function in elderly patients with acute ST-segment elevation myocardial infarction. Methods 123 cases of acute ST-segment elevation myocardial infarction admitted from June 2012 to June 2016 in our hospital were randomly divided into experimental group and control group according to the random number table method. There were 63 cases in trial group and control group 60 cases. Patients in the experimental group were treated with easy-to-treat PCI, and patients in the control group were treated with direct PCI. Left ventricular remodeling and cardiac function were compared between the two groups. Measurement data were compared between two groups using independent samples t test, the group was compared using paired t test; count data usingχ ~ 2 test, P <0.05 for the difference was statistically significant. Results Before and after treatment, the left ventricular end systolic volume index (LVESVI) [(33.14 ± 9.86), (30.41 ± 8.03) ml / m ~ 2 and (33.65 ± 10.23), (29.25 ± 7.28 ), left ventricular end diastolic volume index (LVEDVI) (64.53 ± 12.34), (61.39 ± 10.52) ml / m ~ 2 and (63.96 ± 12.55), (60.06 ± 11.78) ml / m ~ 2], left ventricular shortening fraction (LVSF) [(27.87 ± 5.63)%, (33.45 ± 5.92)% and (27.11 ± 5.38)%, (32.75 ± 6.12 )%], The differences were statistically significant (all P <0.05). One week after treatment, left ventricular ejection fraction (LVEF) between the two groups showed statistically significant difference (P <0.05). The peak ejection rate (PER) [(1.31 ± 0.08), (1.65 ± 0.11) EDV / s and (1.30 ± 0.07), (1.62 ± 0.09) EDV / s] (1.39 ± 0.13), (1.92 ± 0.22) EDV / s and (1.41 ± 0.14), (1.85 ± 0.21) EDV / s], LVEF [(39.85 ± 4.02)%, 50.16 ± 5.26% and (39.15 ± 4.18)%, (45.37 ± 4.97)%, respectively. There were significant differences between the two groups (all P <0.05). Conclusions Percutaneous coronary intervention in elderly patients with acute ST-segment elevation myocardial infarction may improve left ventricular ejection function, while its efficacy is similar in other cases.