CAJ | 학술논문

目的探讨经皮冠状动脉介入(PCI)序贯治疗对急性ST段抬高型急性心肌梗死(STEMI)患者左心室功能的影响及相关因素.方法对入选的116例STEMI患者按数字表法随机分为序贯PCI组58例和58例,传统PCI组按PCI常规进行,序贯PCI组在传统PCI术前尽量吸量冠状动脉内血栓,然后再按PCI常规进行.比较两组患者在PCI治疗即刻和之后2周时左心室的收缩和舒张功能,并采用Logstic回归分析方法,探讨影响PCI临床效果的相关因素.结果序贯PCI组与传统PCI组比较,局部最大收缩末容积(RESV-max)、局部最小收缩末容积(RESVmin)、局部最大射血分数(REFmax)、局部最大舒张末期容积(REDVmax)、E/A比值等差异均有统计学意义(均P＜0.05);以序贯PCI为变量,对REFmax恢复到50%的影响进行两项Logstic回归分析,序贯PCI治疗方法的OR值为3.47,95%CI为1.39～9.75,P=0.04;影响心肌功能恢复的其它因素还有:发病到血流开始再通的时间(OR=4.59,P=0.01)、梗死面积导联数(OR=4.22,P=0.01)、入院时心功能Killip级别(OR=3.99,P=0.02)和年龄(OR=2.75,P=0.04)等.结论 PCI序贯治疗可促使心功能的恢复,临床效果优于传统PCI治疗方法.
목적 탐토경피관상동맥개입(PCI)서관치료대급성ST단태고형급성심기경사(STEMI)환자좌심실공능적영향급상관인소.방법 대입선적116례STEMI환자안수자표법수궤분위서관PCI조58례화58례,전통PCI조안PCI상규진행,서관PCI조재전통PCI술전진량흡량관상동맥내혈전,연후재안PCI상규진행.비교량조환자재PCI치료즉각화지후2주시좌심실적수축화서장공능,병채용Logstic회귀분석방법,탐토영향PCI림상효과적상관인소.결과 서관PCI조여전통PCI조비교,국부최대수축말용적(RESV-max)、국부최소수축말용적(RESVmin)、국부최대사혈분수(REFmax)、국부최대서장말기용적(REDVmax)、E/A비치등차이균유통계학의의(균P＜0.05);이서관PCI위변량,대REFmax회복도50%적영향진행량항Logstic회귀분석,서관PCI치료방법적OR치위3.47,95%CI위1.39～9.75,P=0.04;영향심기공능회복적기타인소환유:발병도혈류개시재통적시간(OR=4.59,P=0.01)、경사면적도련수(OR=4.22,P=0.01)、입원시심공능Killip급별(OR=3.99,P=0.02)화년령(OR=2.75,P=0.04)등.결론 PCI서관치료가촉사심공능적회복,림상효과우우전통PCI치료방법.
Objective To explore effects of sequel recanalization PCI therapy(primary coronary intervention,PCI) on cardiac function for the patients with acute ST segment elevation myocardial infarction(STEMI),and related factors.Methods 116 patients with STEMI enrolled were divided randomly into two groups:sequel recanalization PCI group(58 cases) and conventional PCI group(58 cases),and the patients of sequel recanalization PCI group were fully absorbed for thrombus before conventional PCI,then compared estoration of their cardiac function of the patients of two groups at once and 2 weeks after PCI procedure,respectively.Meantime to study the effect related-factors for cardiac function by Logistic regression analysis.Results There were significant differences between two groups in RESVmax(P =0.03) 、RESVmin(P = 0.00) 、REFmax(P = 0.00)、 REDVmax(P = 0.01) and the ratio of E/A(P =0.02)(all P＜0.05);it showed that the restoration of cardiac function of sequel recanalization PCI group was faster than that of conventional PCI group.If sequel recanalization PCI served as a variable for predicting REFmax being 50%,the results of logistic regression showed that OR(odds ratio) value was 3.47,95% CI(confidence interval) 1.39-9.75,P =0.04.Among other variables,as was time-to-recanalization(OR =4.59,P =0.01);infarct size(OR =4.59,P=0.01);Kiliip grades(OR = 3.99,P =0.02)and age(OR=2.75,P=0.04).Conclusion The sequel recanalization PCI could be better than conventional PCI for the patients with STEMI in restoration of heart function,but there should be some other effective factors.