临床误诊误治2025，Vol.38Issue(14)：24-28,5.DOI:10.3969/j.issn.1002-3429.2025.14.006
PCI术中球囊缓慢撤压对急性ST段抬高型心肌梗死患者术后即刻及近期疗效的影响
Effect of Slow Balloon Decompression during PCI on the Immediate and Short-term Postoperative Efficacy of Patients with Acute ST-segment Elevation Myocardial Infarction
摘要
Abstract
Objective TTo explore the effect of slow balloon decompression during percutaneous coronary intervention(PCI)on the immediate and short-term postoperative efficacy of patients with acute ST-segment elevation myocardial infarction(ASTEMI).Methods A total of 96 patients with ASTEMI who were admitted from January 2021 to December 2023 were selected and divided into two groups with 48 patients in each group by random number table method.Both groups underwent PCI.In the observation group,slow balloon decompression was performed during the operation,while in the control group,conventional balloon decompression was performed during the operation.The myocardial perfusion indicators[thrombolysis in myocardial infarction(TIMI)blood flow grading,TIMI myocardial perfusion grading(TMPG),corrected TIMI flowmeter frame count(cTFC),ST-segment fallback rate(STR),no-reflow rate(NR)/incidence of slow blood flow(SF)]of the two groups were compared,Myocardial injury indicators[troponin I(cTnI),myocardial creatine kinase isoenzyme(CK-MB)]before surgery and at 24 h after surgery,cardiac function indicators[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)]before surgery and at 1 month after surgery,and at 6 months after surgery,as well as the incidence of bleeding events were also compared between the two groups.The incidence of major adverse cardiovascular events(MACE)within 6 months after surgery in the two groups was also statistically analyzed.Results The TIMI blood flow grading,TMPG and cTFC in the two groups immediately after the operation were significantly improved compared with those before the operation,and which were superior in the observation group than in the control group(P<0.05).Immediately after surgery,the observation group had a higher STR and a lower NR/SF incidence than the control group(P<0.05).Compared with those before surgery,serum cTnI and CK-MB levels decreased at 24 h and one week after surgery in both groups(P<0.05);the observation group had lower levels of serum cTnI and CK-MB at 24 h and one week after surgery than the control group(P<0.05).Compared with those before surgery,LVEDD and LVESD decreased at one month and 6 months after surgery in both groups(P<0.05);the observation group had lower LVEDD and LVESD at one month and six months after surgery than the control group(P<0.05).The results of univariate and multivariate analyses based on generalized estimating equation models revealed significant differences in interaction between groups,time points and time points between groups with respect to serum cTnI,CK-MB,LVEDD,and LVESD(P<0.01).There was no significant difference in the overall incidence of bleeding events between the two groups at 24 h after surgery(P>0.05).The observation group had a lower incidence of MACE at six months after surgery than the control group(P<0.05).Conclusion Slow balloon decompression during PCI in patients with ASTEMI can reduce the occurrence of NR and SF,increase myocardial blood perfusion volume,alleviate myocardial injury,improve cardiac function,and reduce the risk of postoperative MACE,which is beneficial to the short-term prognosis.关键词
ST段抬高型心肌梗死/经皮冠状动脉介入治疗/球囊缓慢撤压/肌钙蛋白I/左心室舒张末期内径/不良心血管事件Key words
ST-segment elevation myocardial infarction/Percutaneous coronary intervention/Slow balloon decompression/Troponin I/Left ventricular end-diastolic diameter/Adverse cardiovascular event分类
医药卫生引用本文复制引用
王婷婷,尚亚东,瞿晓雅,程仁力..PCI术中球囊缓慢撤压对急性ST段抬高型心肌梗死患者术后即刻及近期疗效的影响[J].临床误诊误治,2025,38(14):24-28,5.基金项目
安徽省教育厅2020年高等学校省级质量工程项目(2020jyxm0935) （2020jyxm0935）
2023年度宿州市自筹资金项目(SZZCZJ202334) （SZZCZJ202334）
