CAJ | 학술논문

目的：探讨急诊经皮冠状动脉介入治疗（PCI）术中脉搏血氧饱和度（SpO2）水平与急性 ST段抬高型心肌梗死（STEMI）患者临床疗效和预后的关系。方法选择进行急诊PCI术的STEMI患者126例，依据 SpO2水平分为观察组58例（SpO2＜90％）和对照组68例（SpO2＞90％）。观察两组患者冠状动脉血管病变支数，术后4周的左室收缩末期容积（LVESV）、舒张末期容积（LVEDV）和左室射血分数（LVEF）；两组患者住院期间及术后1 a时的主要心脏不良事件和6 min步行试验。结果观察组冠状动脉病变支数较对照组高[P＜0．05]，前降支为梗死相关血管的比例多于对照组（P＜0．05）；术后4周观察组的 LVESV 、LVEDV 较对照组高，LVEF 较对照组低，差异有统计学意义。观察组住院期间及1 a时的主要不良心脏事件较对照组高，1 a时的6 min步行试验的步行距离较对照组短，差异有统计学意义。结论急诊 PCI 术中脉搏血氧饱和度水平是评价 STEMI 患者临床疗效和预后的一种可靠指标，有利于指导临床实践。
목적：탐토급진경피관상동맥개입치료（PCI）술중맥박혈양포화도（SpO2）수평여급성 ST단태고형심기경사（STEMI）환자림상료효화예후적관계。방법선택진행급진PCI술적STEMI환자126례，의거 SpO2수평분위관찰조58례（SpO2＜90％）화대조조68례（SpO2＞90％）。관찰량조환자관상동맥혈관병변지수，술후4주적좌실수축말기용적（LVESV）、서장말기용적（LVEDV）화좌실사혈분수（LVEF）；량조환자주원기간급술후1 a시적주요심장불량사건화6 min보행시험。결과관찰조관상동맥병변지수교대조조고[P＜0．05]，전강지위경사상관혈관적비례다우대조조（P＜0．05）；술후4주관찰조적 LVESV 、LVEDV 교대조조고，LVEF 교대조조저，차이유통계학의의。관찰조주원기간급1 a시적주요불양심장사건교대조조고，1 a시적6 min보행시험적보행거리교대조조단，차이유통계학의의。결론급진 PCI 술중맥박혈양포화도수평시평개 STEMI 환자림상료효화예후적일충가고지표，유리우지도림상실천。
Objective To investigate the relationship between pulse oxygen saturation (SpO2 ) during primary percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction (STEMI)and its clinical efficacy and prognostic value. Methods We studied 126 STEMI patients who monitored pulse oxygen saturation continuously during primary PCI.According to the SpO2 ,the patients were divided into the observation group(n=58,SpO2 <90%)and the observation group (n=68,SpO2 >90%), observing the number of the stenotic vessls,left ventricular end-systolic volume (LVESV ),left ventricular end-diastolic volume(LVEDV)and left ventricular ejection fraction (LVEF)4 weeks after PCI,and also analyzing the major adverse cardiac events (MACE ) and six-minute walk test between the hospitalization period and 1 year after PCI. Results There were no significant differences in sex,age,susceptible factors (eg hypertension,hyperlipidemia,diabetes mellitus,smoking,et al),hemoglobin level,original heart disease history,door to balloon time and the number of stent implantation between the two groups in the baseline characteristics.The number of the stenotic vessls in the observation group was more than the observation group [P<0.05],and the percentage of infarct-related artery in the left anterior descending artery was also higher (P<0.05).The diameters of LVESV,LVEDV were larger,and the LVEF was lower than the control group. The incidence of MACE between the hospitalization period and 1 month after PCI in the observation group was higher,while shorter with the six-minute walk test than the control group. Conclusion The SpO2 during primary PCI with STEMI is a reliable index in evaluating the clinical efficacy and prognostic value,which can guide clinical practice.