经桡动脉途径行经皮冠状动脉介入治疗对急性心肌梗死患者术后血清脑钠肽、纤维蛋白原、前清蛋白水平的影响

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目的探讨经桡动脉途径行经皮冠状动脉介入治疗(PCI)对急性心肌梗死患者术后血清脑钠肽(BNP)、纤维蛋白原(Fg)、前清蛋白(PA)水平的影响。方法选取上海市第十人名医院2016年5月—2017年2月收治急性心肌梗死患者73例,根据手术方案分为对照组36例和观察组37例。在基础治疗基础上,对照组患者经股动脉途径行PCI,而观察组患者经桡动脉途径行PCI。比较两组患者手术成功率、血管穿刺时间、心肌再灌注时间、卧床时间、出院时间,手术前后血清BNP、Fg、PA水平,术后并发症发生情况。结果两组患者手术成功率、血管穿刺时间及心肌再灌注时间比较,差异无统计学意义(P>0.05);观察组患者卧床时间及出院时间短于对照组(P<0.05)。两组患者术前血清BNP、Fg、PA水平比较,差异无统计学意义(P>0.05);观察组患者术后血清BNP、Fg水平低于对照组,血清PA水平高于对照组(P<0.05)。观察组患者术后并发症发生率低于对照组(P<0.05)。结论经桡动脉途径行经皮冠状动脉介入治疗可有效降低急性心肌梗死患者血清BNP、Fg、PA水平,缩短患者卧床时间及出院时间,且术后并发症发生率低。 Objective To investigate the effect of percutaneous coronary intervention (PCI) on the levels of serum brain natriuretic peptide (BNP), fibrinogen (Fg) and prealbumin (PA) in patients with acute myocardial infarction after transradial approach. Methods Totally 73 patients with acute myocardial infarction who were admitted to Shanghai Tenth Hospital from May 2016 to February 2017 were divided into control group (36 cases) and observation group (37 cases). On the basis of basic treatment, patients in the control group underwent PCI through the femoral artery, while those in the observation group received PCI through the radial artery. The success rates of operation, vascular puncture time, myocardial reperfusion time, bed rest time, discharge time, serum BNP, Fg, PA levels before and after surgery were compared between the two groups. Results There was no significant difference in operative success rate, vascular puncture time and myocardial reperfusion time between the two groups (P> 0.05). The time of bed rest and discharge in the observation group was shorter than that of the control group (P <0.05). There was no significant difference in serum BNP, Fg and PA levels between the two groups before operation (P> 0.05). The levels of serum BNP and Fg in the observation group were lower than those in the control group, and serum PA level was higher than that in the control group (P < 0.05). The incidence of postoperative complications in observation group was lower than that in control group (P <0.05). Conclusions Percutaneous coronary intervention via radial artery can effectively reduce the levels of serum BNP, Fg and PA in patients with acute myocardial infarction, shorten the time of bed rest and discharge in patients, and the incidence of postoperative complications is low.
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