内科

目的探讨不同时机介入治疗对非ST段抬高型心肌梗死（NSTEMI）患者心肌酶、心功能和预后的影响。方法选择2016年12月至2018年12月我院收治的NSTEMI患者82例，采用随机数字法分为对照组与观察组，每组41例。观察组患者入院后48 h内给予血管造影及PCI术治疗，对照组患者入院保守治疗1周后再给予血管造影及PCI术治疗。比较两组患者介入治疗前后的心肌酶水平、心功能及术后6个月不良事件发生情况。结果介入治疗前，两组患者的肌钙蛋白T（cTnT）、肌酸激酶（CK）和同工酶（CK-MB）水平比较，差异无统计学意义（P＞0.05）；介入治疗后，两组患者的cTnT、CK和CK-MB水平均显著降低，但两组患者的cTnT、CK和CK-MB水平比较差异无统计学意义（P＞0.05）。介入治疗前，两组患者的左室射血分数（LVEF）、左室收缩末期内径（LVEDs）和左室舒张末期内径（LVEDd）比较差异无统计学意义（P＞0.05）。介入治疗后，两组患者的LVEF均升高，LVEDs和LVEDd均降低；观察组患者的LVEF显著高于对照组，而LVEDs和LVEDd显著低于对照组，差异有统计学意义（P＜0.05）。介入治疗后随访6个月，观察组患者的不良事件发生率（2.44%）显著低于对照组（21.95%），差异有统计学意义（P＜0.05）。结论不同时机介入治疗对NSTEMI患者的心肌酶水平无明显影响，早期介入治疗可更明显地改善患者的心功能、减少不良事件的发生。

ObjectiveTo investigate the effects of interventional therapy at different opportunities on myocardial enzyme, cardiac function, and prognosis in patients with non-ST-segment elevation myocardial infarction (NSTEMI). MethodsA total of 82 patients with NSTEMI admitted to our hospital from December 2016 to December 2018 were selected and divided into control group and observation group in accordance with the random number method, with 41 cases in each group. Patients in the observation group were administered angiography and PCI within 48 hours after admission; whereas after one week of conservative treatment, the control group were administered angiography and PCI. Myocardial enzyme level, cardiac function, and the six-month postoperative prevalence of adverse events were compared between the two groups. ResultsThere were no statistically significant differences in the levels of troponin T (cTnT), creatine kinase (CK) and isoenzyme (CK-MB) between the two groups before interventional therapy (P＞0.05). After interventional therapy, the levels of cTnT, CK and CK-MB significantly decreased in the two groups, but there were no statistically significant differences in cTnT, CK and CK-MB levels between the two groups (P＞0.05). There were no statistically significant differences in left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVEDs), and left ventricular end-diastolic diameter (LVEDd) between the two groups before interventional therapy (P＞0.05). After interventional therapy, LVEF in both groups increased, whereas LVEDs and LVEDd decreased. Compared to the control group, patients in the observation group obtained higher LVEF, but lower LVEDs and LVEDd, with statistically significant differences (P＜0.05). Six-month follow-up after interventional therapy, the incidence of adverse events in the observation group was significantly lower than that in the control group (2.44% vs. 21.95%), with statistically significant difference (P＜0.05). ConclusionInterventional therapy at different opportunities has no significant effect on myocardial enzyme level in patients with NSTEMI. Early interventional therapy can significantly improve cardiac function of patients and reduce the occurrence of adverse events.