心脏支架介入与溶栓血运重建再灌注在ST段抬高急性心肌梗死患者中的应用(1)
[摘要]目的 探讨心脏支架介入与溶栓血运重建再灌注在ST段抬高急性心肌梗死(STEMI)患者中的应用。方法 选择2016年12月～2018年10月我院收治的46例STEMI患者作为研究对象，按照随机数字表法分为对照组(23例)和观察组(23例)，对照组患者采用心脏支架介入治疗，观察组患者采用溶栓血运重建再灌注治疗，观察两组患者的血清心肌坏死标志物及炎症因子、左室射血分数(LVEF)和左室舒张末期内径(LVEDD)和主要终点事件(死亡率、再次心肌梗死率)。结果 观察组的肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、血清超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-10(IL-10)低于对照组，差异有统计学意义(P<0.05);观察组患者的LVEF高于对照组、LVEDD低于对照组，差异有统计学意义(P<0.05);观察组患者的死亡率、再次心肌梗死率低于对照组，差异有统计学意义(P<0.05)。结论 溶栓血运重建再灌注治疗STEMI的效果更加显著，能够有效地改善患者的相关指标，相较于心脏支架介入治疗更有优势，适合在临床进行展开和实施。
[关键词]ST段抬高急性心肌梗死;心脏支架介入;溶栓血运重建再灌注;治疗效果;比较
[Abstract] Objective To investigate the application of cardiac stenting and thrombolysis and reperfusion in patients with ST-segment elevation acute myocardial infarction (STEMI). Methods Forty-six patients with STEMI admitted to our hospital from December 2016 to October 2018 were enrolled in the study. They were divided into control group (n=23) and observed group (n=23) according to the random number table method. The patients in the control group were treated with cardiac stenting. The patients in the observation group were treated with thrombolysis and reperfusion. The serum myocardial necrosis markers， inflammatory factors and left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) and primary endpoint (mortality， rate of re-infarction) were observed in the two groups. Results Creatine kinase isoenzyme (CK-MB)， cardiac troponin I (cTnI)， serum high-sensitivity C-reactive protein (hs-CRP)， tumor necrosis factor-α (TNF-α)， interleukin-6 (IL-6) and interleukin-10 (IL-10) were lower than those of the control group， the differences were statistically significant (P<0.05). The LVEF of the observation group was higher than that of the control group and LVEDD was lower than the control group， the difference was statistically significant (P<0.05). The mortality and re-infarction rate of the observation group were lower than those of the control group， and the differences were statistically significant (P<0.05). Conclusion The effect of thrombolysis and reperfusion treating STEMI is more significant， and it can effectively improve the relevant indicators of patients. It is more advantageous than cardiac stenting and is suitable for clinical development and implementation.
[Key words] ST-segment elevation acute myocardial infarction; Cardiac stent intervention; Thrombolysis and reperfusion; Therapeutic effect; Comparison
ST段抬高急性心肌梗死(STEMI)，在臨床上比较常见，具有较高的致死率和致残率，严重威胁患者的生命安全[1]。STEMI的临床表现复杂，高血压、血脂异常均是其常见的并发症[2]。心肌能力的丧失表现为4个方面的异常[3]：①同步异常，也就是病变心肌与其临近的正常心肌的收缩不一致[4]。②收缩运动减弱，也就是肌肉变化的幅度变小[5]。③无收缩运动，也就是心肌无运动[6]。④反常收缩，也就是收缩期反而膨胀[7]。目前临床上对于STEMI的治疗，主要有两种方式，心脏支架介入与溶栓血运重建再灌注治疗效[8]，这两种方式各有利弊，也各有优缺点，在临床上如何选择，是很多医院和医生研究的重点课题。本研究将对这两种方式进行对比和分析，现报道如下。, http://www.100md.com(程乾堃)
[关键词]ST段抬高急性心肌梗死;心脏支架介入;溶栓血运重建再灌注;治疗效果;比较
[Abstract] Objective To investigate the application of cardiac stenting and thrombolysis and reperfusion in patients with ST-segment elevation acute myocardial infarction (STEMI). Methods Forty-six patients with STEMI admitted to our hospital from December 2016 to October 2018 were enrolled in the study. They were divided into control group (n=23) and observed group (n=23) according to the random number table method. The patients in the control group were treated with cardiac stenting. The patients in the observation group were treated with thrombolysis and reperfusion. The serum myocardial necrosis markers， inflammatory factors and left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) and primary endpoint (mortality， rate of re-infarction) were observed in the two groups. Results Creatine kinase isoenzyme (CK-MB)， cardiac troponin I (cTnI)， serum high-sensitivity C-reactive protein (hs-CRP)， tumor necrosis factor-α (TNF-α)， interleukin-6 (IL-6) and interleukin-10 (IL-10) were lower than those of the control group， the differences were statistically significant (P<0.05). The LVEF of the observation group was higher than that of the control group and LVEDD was lower than the control group， the difference was statistically significant (P<0.05). The mortality and re-infarction rate of the observation group were lower than those of the control group， and the differences were statistically significant (P<0.05). Conclusion The effect of thrombolysis and reperfusion treating STEMI is more significant， and it can effectively improve the relevant indicators of patients. It is more advantageous than cardiac stenting and is suitable for clinical development and implementation.
[Key words] ST-segment elevation acute myocardial infarction; Cardiac stent intervention; Thrombolysis and reperfusion; Therapeutic effect; Comparison
ST段抬高急性心肌梗死(STEMI)，在臨床上比较常见，具有较高的致死率和致残率，严重威胁患者的生命安全[1]。STEMI的临床表现复杂，高血压、血脂异常均是其常见的并发症[2]。心肌能力的丧失表现为4个方面的异常[3]：①同步异常，也就是病变心肌与其临近的正常心肌的收缩不一致[4]。②收缩运动减弱，也就是肌肉变化的幅度变小[5]。③无收缩运动，也就是心肌无运动[6]。④反常收缩，也就是收缩期反而膨胀[7]。目前临床上对于STEMI的治疗，主要有两种方式，心脏支架介入与溶栓血运重建再灌注治疗效[8]，这两种方式各有利弊，也各有优缺点，在临床上如何选择，是很多医院和医生研究的重点课题。本研究将对这两种方式进行对比和分析，现报道如下。, http://www.100md.com(程乾堃)
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