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目的:探讨入院时心肌肌钙蛋白I(cTnI)水平对急性心肌梗死再灌注患者心功能的影响。方法:95例患者因ST段抬高的急性心肌梗死(STEAMI)行直接经皮冠状动脉成型术(PCI),根据入院时cTnI水平分成cTnI正常组(45例)和cTnI升高组(50例)。观察住院期间通过心脏超声检查的心脏收缩功能和抗心力衰竭药物使用情况。结果:患者的一般临床特征中,cTnI升高组入院时的胸痛持续时间长、CK-MB峰值高(P<0.05)。两组比较,cTnI升高组左室收缩末容积显著增大、左室射血分数显著降低、室壁瘤的发生率高(P<0.05),地高辛和利尿剂的使用率高(P<0.05)。结论:STEAMI患者入院时cTnI升高心脏收缩功能差,应密切观察心功能,及早采取措施防治急性心力衰竭。
Objective: To investigate the influence of cardiac troponin I (cTnI) on cardiac function in patients with acute myocardial infarction and reperfusion on admission. Methods: Ninety-five patients underwent direct percutaneous transluminal coronary angioplasty (PCI) due to ST-elevation acute myocardial infarction (STEAMI). According to cTnI level at admission, they were divided into normal cTnI group (45 cases) and cTnI elevated group ). Cardiac systolic function and anti-heart failure drug use observed during hospitalization by echocardiography were observed. Results: The general clinical features of patients with elevated cTnI group had long duration of chest pain and high CK-MB at admission (P <0.05). In both groups, left ventricular end-systolic volume increased significantly, left ventricular ejection fraction decreased, the incidence of ventricular aneurysm was higher (P <0.05), digoxin and diuretic were higher (P <0.05). Conclusion: STEAMI patients with cTnI elevated cardiac systolic dysfunction, admission should be closely observed, early measures to prevent and treat acute heart failure.