| Objective:To explore the effect of different timing of percutaneous coronary intervention(percutaneous coronary intervention,PCI)on the prognosis in patients with ST-segment elevation myocardial infarction(ST-segment elevation myocardial infarction,STEMI)and diabetes mellitus(DM).Methods:A total of 83 patients with STEMI combined with DM who were treated by PCI in the first hospital of Shanxi Medical University were collected from January 2014 to March 2017 as the research object,and the cases were retrospectively analyzed.According to the incidence distance of PCI time was divided into two groups: the early group was <12 hours(n=43),male 26 cases,female 17 cases,age(58.63±13.99)years old,the selected group(n=40),male 27 cases,female 13 cases,age(58.23±7.23)years old.All patients were collected and the results of laboratory examinations were recorded,and the relative indices of resting gated myocardial perfusion tomography during hospitalization and 6 months after operation were observed,as well as the incidence of major adverse cardiac events(MACE)during the follow-up period of 1 years.The above data were analyzed by statistical method,compared two groups of patients with serum amino-terminal B-type natriuretic peptide(NT-pro BNP)content,left ventricular ejection fraction(LVEF),left ventricular end systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),myocardial perfusion defect area and long-term prognosis.Results:There were no significant differences in serum NT-pro BNP levels between the two groups at admission and on the second day of admission(P>0.05).On the second day of admission,the serum NT-pro BNP levels in early group were lower than those at admission,and the difference was statistically significant(P<0.05);The serum NT-pro BNP levels in the selected group were higher than those at admission,with the difference was not statistically significant(Z=1.902,P=0.057).On the 3rd and 7th day of admission,the serum NT-pro BNP levels of both groups were significantly lower than those at admission,and the early group was significantly lower than the elective group.The difference was statistically significant(P<0.05).There was no statistically significant difference between the LVEF,LVEDV,LVESV and myocardial perfusion defects in the two groups of patients during hospitalization(p>0.05).6 months after PCI treatment,the two groups of LVEF,LVEDV,LVESV were improved.After the operation,LVEDV and LVESV were significantly lower in the early group than in the selected group,and LVEF was significantly higher than the selected group,the difference was statistically significant(p<0.05).The area of myocardial perfusion defect was decreased in the two groups after operation,and the difference in the observation group was statistically significant(P<0.05),and no difference was found in the control group(t=1.454,P=0.154).The area of myocardial perfusion defect in the early group was significantly lower than that in the selected group,and the difference was statistically significant(p<0.05).After 1 years of follow-up after PCI,the results showed that the early group was significantly lower than the selected group in the compound endpoint events,PCI,malignant heart failure and cardiac death,the difference was statistically significant(p<0.05).Conclusion:Interventional treatment can effectively reduce the damage degree of myocardial cells and improve left ventricular function in patients with acute ST-segment elevation myocardial infarction complicated with diabetes?the earlier the intervention treatment,the less damage to myocardial cells,and can reduce the infarct size,it is of great clinical significance to restore the left cardiac function of patients and improve the prognosis. |
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