优化后适应术式对急诊经皮冠状动脉介入术急性心肌梗死患者心肌再灌注损伤的影响.docxVIP

优化后适应术式对急诊经皮冠状动脉介入术急性心肌梗死患者心肌再灌注损伤的影响 　　[摘要]目的探究优化后适应术式对急诊经皮冠状动脉介入术（pci）急性心肌梗死患者心肌再灌注损伤的影响。方法选取2018年3月～2019年9月我院收治的进行急诊pci的60例急性心肌梗死患者作为研究对象，将所有患者按照隨机数字表法分为对照组（30例）和优化组（30例）。对照组患者实施常规的pci治疗，优化组患者实施优化后适应术式的pci治疗。比较两组患者院内最高和出院前的肌酸激酶同工酶（ck-mb）和氨基末端脑钠肽前体（nt-probnp）水平的差值（△ck-mb、△nt-probnp），比较两组患者术后及术后1个月心脏彩超进行相关指标。结果优化组患者△ck-mb、△nt-probnp高于对照组，差异有统计学意义（p0.05）。术后即刻，两组患者左心房内径（la）、左心室舒张期内径（lvdd）、左心室收缩期内径（lvds）、射血分数（ef）水平比较，差异无统计学意义（p0.05）。术后1个月，优化组患者lvds和ef值高于对照组，差异有统计学意义（p0.05）。结论对急性心肌梗死患者实施优化后适应术式的pci治疗，能够有效改善患者心肌状态，提高心功能水平，达到更好的治疗效果。 　　[关键词]经皮冠状动脉介入术;优化后适应术式;心肌再灌注损伤;急诊 　　[abstract]objectivetoexploretheinfluenceofoptimizedoperationmodeonmyocardialreperfusioninjuryinpatientswithacutemyocardialinfarctionundergoingemergencypercutaneouscoronaryintervention（pci）.methodsfrommarch2018toseptember2019，60patientswithacutemyocardialinfarctionwhounderwentemergencypciwereselectedasthestudyobjects.allpatientsweredividedintocontrolgroup（30cases）andoptimizationgroup（30cases）accordingtorandomnumbertablemethod.thepatientsinthecontrolgroupweretreatedwithconventionalpci，andthepatientsintheoptimizationgroupweretreatedwithpciwhichwassuitableforcomfort.thedifferencesofcreatinekinaseisoenzyme（ck-mb）andaminoterminalprobrainnatriureticpeptide（nt-probnp）betweenthetwogroups（△ck-mb，△nt-probnp）werecompared.theindexesofcolordopplerechocardiographywerecomparedbetweenthetwogroups.resultsthe△ck-mband△nt-probnpintheoptimizedgroupwerehigherthanthoseinthecontrolgroup，thedifferenceswerestatisticallysignificant（p0.05）.immediatelyaftersurgery，therewerenosignificantdifferencesbetweenthetwogroupsinleftatrialdiameter（la），leftventriculardiastolicdiameter（lvdd），leftventricularsystolicdiameter（lvds）andejectionfraction（ef）（p0.05）.onemonthaftertheoperation，thelvdsandefofthepatientsintheoptimizationgroupwerehigherthanthoseinthecontrolgroup，thedifferenceswerestatisticallysignificant（p0.05）.conclusiontheoptimizedpciforpatientswithacutemyocardialinfarctioncaneffectivelyimprovethemyocardialstatusandimprovethelev