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目的比较不同时机经皮冠状动脉介入术(PCI)对急性心肌梗死(AMI)患者的影响。方法选取2013年4月—2016年4月新汶矿业集团有限责任公司华丰煤矿医院收治的AMI患者90例,均于12 h内行PCI,根据发病至PCI时间分为A组(发病至PCI时间<3 h,n=32)、B组(3 h≤发病至PCI时间<6 h,n=31)和C组(6 h≤发病至PCI时间<12 h,n=27)。比较3组患者临床疗效、心脏不良事件发生情况及心肌改善情况[包括左心室射血分数(LVEF)、肌酸激酶同工酶(CK-MB)恢复时间、肌酸激酶(CK)恢复时间]。结果 A组患者临床疗效优于C组(P<0.05)。A组、B组患者心脏不良事件发生率低于C组(P<0.05)。A组患者术后LVEF高于B组、C组,B组患者术后LVEF高于C组(P<0.05);A组患者CK-MB恢复正常时间、CK恢复正常时间短于B组、C组,B组患者CK-MB恢复正常时间、CK恢复正常时间短于C组(P<0.05)。结论 PCI时机对AMI患者有一定影响,超早期(发病至PCI时间<3 h)及早期(3 h≤发病至PCI时间<6 h)PCI治疗AMI患者的临床疗效较好,可更有效地降低心脏事件发生风险,改善患者心肌功能,且超早期PCI效果最佳。
Objective To compare the effects of percutaneous coronary intervention (PCI) on patients with acute myocardial infarction (AMI) at different time points. METHODS: Ninety AMI patients admitted to Huafeng Coal Mine Hospital of Xinwen Mining Group Co., Ltd. from April 2013 to April 2016 were enrolled in this study. They were all performed PCI within 12 hours and were divided into group A (onset to PCI time) N = 32), group B (3 h≤ onset to PCI <6 h, n = 31) and group C (6 h≤lip to PCI <12 h, n = 27). The clinical efficacy, cardiac adverse events and myocardial improvement (including left ventricular ejection fraction (LVEF), creatine kinase isoenzyme (CK-MB) recovery time and creatine kinase (CK) recovery time) . Results The clinical efficacy of group A was better than that of group C (P <0.05). The incidence of cardiac adverse events in group A and group B was lower than that in group C (P <0.05). LVEF in group A was higher than that in group B, LVEF in group C and group B was significantly higher than that in group C (P <0.05); Group C was shorter than group B Group B, CK-MB recovery time of normal patients, CK recovery time is shorter than the normal group C (P <0.05). Conclusions PCI timing has some effect on patients with AMI. The clinical effect of AMI in patients with early PCI (onset to PCI time <3 h) and early (3 h≤ onset to PCI time <6 h) PCI is better and can be more effectively reduced Risk of cardiac events, improve myocardial function in patients, and ultra-early PCI best.