集束化干预措施在中老年急性心肌梗死患者中的应用及对微小RNA指标影响

摘要

目的 研究集束化干预措施在中老年急性心肌梗死患者中的应用及对微小RNA-208b指标的影响.方法 选择2016年1月至2017年10月期间在本院接受诊治的158例急性心肌梗死患者作为观察对象,参照随机数表法分成对照组、研究组,各79例.对照组患者接受常规临床护理,研究组患者在常规护理基础上开展集束化护理干预,对比两组患者干预前后心理健康水平、血浆微小RNA-208b指标变化及不良心脏事件发生率.结果 干预后两组患者的SAS、SDS评分均低于干预前,且研究组低于对照组,差异均有统计学意义(均P＜ 0.05);干预后对照组患者微小RNA-208b水平为(3.0±1.3),研究组为(1.6±0.44);两组患者干预后的微小RNA-208b水平均低于干预前,且研究组低于对照组,差异均有统计学意义(均P＜ 0.05);研究组不良心脏事件发生率为8.9％(7/79),低于对照组的20.3％(16/79),差异有统计学意义(P＜0.05).结论 集束化干预措施在中老年急性心肌梗死患者中的应用效果显著,能有效提高患者心理健康水平,减少不良心脏事件发生,降低微小RNA-208b指标表达水平,改善心肌缺血再灌注情况,提高预后,值得临床推广.%Objective To study the application of clustering intervention in middle-aged and elderly patients with acute myocardial infarction and the impact on microRNA-208b indicators.Methods 158 patients with acute myocardial infarction who were diagnosed and treated in our hospital from January,2016 to October,2017 were selected as observation objects.They were divided into a control group and a study group according to the random number table method,79 cases for each group.The control group received routine clinical care,and the study group clustering nursing intervention and routine care.The levels of mental health,changes in plasma microRNA-208b,and incidences of adverse cardiac events before and after intervention were compared between the two groups.Results After the intervention,the SAS and SDS scores of the two groups were lower than those before the intervention,and those in the study group was lower than those the control group,with statistical differences (P＜0.05).The level of microRNA-208b was lower after than before the intervention in the two groups,and were lower in the study group than in the control group after the intervention [(1.6±0.44) vs.(3.0±1.3)].The incidence of adverse cardiac events was was lower in the study group than in the control group [8.9％ (7/79)vs.20.3％ (16/79),P ＜ 0.05].Conclusions Clustering intervention has significant effect on middle-aged and elderly patients with acute myocardial infarction.It can effectively improve the level of mental health,myocardial ischemia,reperfusion,and prognosis,and reduce the occurrence of adverse cardiac events and the expression level of microRNA-208b indicators.