本文選題：急性ST段抬高型心肌梗死　切入點：脈壓　出處：《中華高血壓雜志》2016年05期

【摘要】：目的評價脈壓與急性ST段抬高型心肌梗死(ASTEMI)患者行經皮冠狀動脈介入術(PCI)近期療效的關系。方法回顧性分析2011年1月至2015年6月ASTEMI行PCI治療的患者389例,根據脈壓分為A組:脈壓≤20mm Hg,n=122;B組:脈壓20~60mm Hg,n=138;C組:脈壓60mm Hg,n=129。觀察不同脈壓組患者冠狀動脈病變嚴重程度;PCI術前、術后罪犯血管心肌梗死溶栓試驗(TIMI)的血流情況,惡性心律失常的發(fā)生情況;觀察血清肌酸激酶同工酶(CK-MB)、心肌肌鈣蛋白I(cTn-I)、血漿氨基末端腦鈉尿肽前體(NT-proBNP)峰值情況;對比術后1周6min步行距離;對比術后1周死亡情況;對比PCI術后1周與術前脈壓的變化。結果冠狀動脈病變累及血管數與累及部位由輕及重依次為B組、C組、A組(均P0.05);3組罪犯血管PCI術前血流情況差異有統(tǒng)計學意義,B組優(yōu)于C組,更優(yōu)于A組(均P0.05),PCI術后差異無統(tǒng)計學意義(均P0.05)。術中、術后惡性心律失常的發(fā)生由少到多依次為B組、C組、A組,3組間差異有統(tǒng)計學意義(P0.05)。PCI術后CK-MB、cTn-I、NT-proBNP峰值3組間對比均表現為B組C組A組[CK-MB:(57.3±26.4)比(89.4±39.6)比(112.5±48.2)U/L,P0.05;cTn-I:(11.8±5.2)比(15.5±6.4)比(35.0±16.9)μg/L,P0.05;NT-proBNP:(1027.6±629.7)比(2301.1±712.5)比(3239.3±873.6)ng/L,P0.05]。6 min步行距離B組優(yōu)于C組,更優(yōu)于A組[(510.7±97.9)比(451.2±92.6)比(378.4±85.6)m,P0.05]。全因死亡、心源性死亡發(fā)生率表現為A組C組B組,3組間差異有統(tǒng)計學意義(均P0.05)。心源性休克是A組最重要的死亡原因,但3組間心源性死亡病因發(fā)生情況無統(tǒng)計學意義(均P0.05)。PCI術后A組脈壓取得明顯有益的改善。結論脈壓對ASTEMI患者PCI近期預后有一定的預測作用。
[Abstract]:Objective to evaluate the pulse pressure and acute ST elevation myocardial infarction (ASTEMI) undergoing percutaneous coronary intervention (PCI) the relationship between efficacy. Methods: a retrospective analysis of 389 cases from January 2011 to June 2015 ASTEMI PCI patients were divided into A group, according to the pulse pressure pulse pressure less than 20mm Hg, n=122; group B: pulse pressure 20~60mm Hg, n=138; group C: 60mm Hg n=129. to observe the effects of different pulse pressure, pulse pressure in patients with the severity of coronary artery lesions; PCI before surgery, the culprit artery thrombolysis in myocardial infarction (TIMI) postoperative blood flow, arrhythmia; observation of serum creatine kinase isoenzyme (CK-MB), cardiac troponin (I cTn-I), plasma N-terminal pro brain natriuretic peptide (NT-proBNP) peak; contrast after 1 weeks 6min walking distance; contrast died 1 weeks after surgery; 1 weeks before operation and change of pulse pressure after PCI. Comparing the results of coronary vascular lesions involving the number and tired 鍙婇儴浣嶇敱杞誨強閲嶄緷嬈′負B緇，

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