CAJ | 학술논문

目的：探讨急性心肌梗死患者经皮冠状动脉介入术后心率变化与患者预后的关系，为临床治疗提供参考。方法将贵港市人民医院收治的57例急性心肌梗死患者按照心率水平分为研究组（患者心率大于或等于80次/分钟）和对照组（患者心率小于80次/分钟），记录两组患者在住院期间肌酸激酶同工酶（CK-MB）、左心室射血分数（LVEF）和肌钙蛋白 I（TnI）峰值；并比较住院期间患者心力衰竭、心源性休克、主动脉内球囊反搏（IABP）等并发症发生情况。结果研究组 CK-MB（164．5±67．7）U /L 和 TnI 峰值（47．1±30．5）％均明显高于对照组 CK-MB（131．8±71．8）U /L 和 TnI 峰值（33．9±23．9）％，两组差异有统计学意义（P＜0．05）；LVEF（49．2±9．8）ng/mL则显著低于对照组（54．5±10．9）ng/mL ，差异有统计学意义（P＜0．05）。研究组心力衰竭、心源性休克、IABP 及并发症发生率均显著高于对照组，差异有统计学意义（P ＜0．05）。结论经皮冠状动脉介入治疗手术的急性心肌梗死患者术后护理需重视心率变化，出现心率加快的患者应及早通知医生给予适当药物控制，提高心脏功能，改善患者预后。
목적：탐토급성심기경사환자경피관상동맥개입술후심솔변화여환자예후적관계，위림상치료제공삼고。방법장귀항시인민의원수치적57례급성심기경사환자안조심솔수평분위연구조（환자심솔대우혹등우80차/분종）화대조조（환자심솔소우80차/분종），기록량조환자재주원기간기산격매동공매（CK-MB）、좌심실사혈분수（LVEF）화기개단백 I（TnI）봉치；병비교주원기간환자심력쇠갈、심원성휴극、주동맥내구낭반박（IABP）등병발증발생정황。결과연구조 CK-MB（164．5±67．7）U /L 화 TnI 봉치（47．1±30．5）％균명현고우대조조 CK-MB（131．8±71．8）U /L 화 TnI 봉치（33．9±23．9）％，량조차이유통계학의의（P＜0．05）；LVEF（49．2±9．8）ng/mL칙현저저우대조조（54．5±10．9）ng/mL ，차이유통계학의의（P＜0．05）。연구조심력쇠갈、심원성휴극、IABP 급병발증발생솔균현저고우대조조，차이유통계학의의（P ＜0．05）。결론경피관상동맥개입치료수술적급성심기경사환자술후호리수중시심솔변화，출현심솔가쾌적환자응급조통지의생급여괄당약물공제，제고심장공능，개선환자예후。
Objective To investigate the relationship between heart rate and prognosis on acute myocardial in -farction patients after percutaneous coronary intervention ,in order to provide a reference for clinical treatment .Meth-ods 57 cases with acute myocardial infarction in people′s hospital of Guigang after percutaneous coronary interven-tion were divided into two groups according to different heart rate ,one group was study group(patients with heart rate ≥ 80 times / min) ,the other one was control group(heart rate < 80 beats / min) .Creatine kinase(CK-MB) ,left ventricular ejection fraction (LVEF) and troponin I(TnI) peak were compared between the two groups ,and patients with heart failure ,cardiogenic shock ,intra aortic balloon counterpulsation (IABP) the occurrence of complications were compared as well .Results The CK-MB(164 .5 ± 67 .7)U /L and TnI peak(47 .1 ± 30 .5)% of patients in the study group were significantly higher than those in the the control group which were [(131 .8 ± 71 .8)U /L ,(33 .9 ± 23 .9)% ] ,the difference of two groups was statistically significant (P< 0 .05) .Besides the LVEF(49 .2 ± 9 .8)ng/mL in the study group was significantly lower than that of the control group (54 .5 ± 10 .9)ng/mL ,the difference between the two groups was statistically significant ( P < 0 .05 ) .Between the two groups ,heart failure was 13 .89% vs . 4 .76% ,cardiogenic shock was 19 .44% vs .9 .52% ,IABP was 8 .33% vs .0 .00% ,the study group had significantly higher complication rate ,the differences were all statistically significant (P < 0 .05) .Conclusion Changes of heart rate in acute myocardial infarction patients after percutaneous coronary intervention should be noticed especially in nursing process ,and appropriate medication should be used to control heart rate timely ,which could improve heart function and patients'outcomes .