摘要
目的探讨前列地尔对急性心肌梗死患者行急诊经皮冠状动脉介入治疗(PCI)术后心功能的影响。方法选择2013年4月—2014年5月在广东医学院附属厚街医院行急诊PCI的急性心肌梗死患者60例,随机分为试验组和对照组,各30例。两组患者均行急诊PCI,对照组给予硝酸甘油、替非罗班治疗,试验组在对照组治疗基础上于术中在冠状动脉罪犯血管远端注射前列地尔。两组患者均于急诊PCI术后2、4、8、12、16及24 h测定血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、内皮素(ET)和超敏C反应蛋白(hs-CRP)水平;急诊PCI术后24 h和7 d测定N-末端脑钠肽前体(NT-pro BNP)水平和左心室射血分数(LVEF);PCI术后即刻造影示校正的TIMI帧数(CTFC)。结果急诊PCI术后2、4、8、12、16及24 h试验组患者血清CK、CK-MB、LDH、ET、hs-CRP水平均低于对照组(P<0.05);术后24 h两组患者血清NT-pro BNP水平和LVEF比较,差异无统计学意义(P>0.05);术后7 d试验组患者血清NT-pro BNP水平低于对照组,LVEF高于对照组(P<0.05)。PCI术后即刻试验组患者CTFC为(27.13±4.13)帧,低于对照组的(36.24±4.89)帧(P<0.05)。结论急诊PCI术中给予前列地尔可改善急性心肌梗死患者心肌微循环,通过扩张冠状动脉、抗炎等减轻心肌再灌注损伤,进而改善心功能。
Objective To explore the effect of alprostadil on cardiac function of acute myocardial infarction patients treated by emergency percutaneous coronary intervention （PCI）. Methods A total of 60 acute myocardial infarction patients treated by emergency PCI were selected in Houjie Hospital Affiliated to Guangdong Medical College from April 2013 to May 2014, and they were randomly divided into experiment group and control group, each of 30 cases. Control group given nitroglycerin and tirofiban during emergency PCI, and experiment group given extra alprostadil. Serum levels of CK, CK -MB, LDH, ET, hs - CRP were detected after 2, 4, 8, 12, 16 and 24 hours of emergency PCI; plasma NT -proBNP level and LVEF were examined after 24 hours and 7 days of emergency PCI. Corrected CTFC was examined after emergency PCI. Results Serum levels of CK, CK - MB, LDH, ET, hs - CRP were lower than those of control group after 2, 4, 8, 12, 16 and 24 hours of emergency PCI （ P 〈 0. 05 ）. No significant differences was found of plasma NT - proBNP level and LVEF between the two groups after 24 hours of emergency PCI （ P 〉 0. 05 ） ; while plasma NT - proBNP level of experiment group was lower than that of control group, LVEF was higher than that of control group after 7 days of emergency PCI （ P 〈 0. 05 ）. The corrected CTFC of experiment group was （27.13 ± 4. 13）, was less than that of control group of （36. 24 ± 4. 89 ） （P 〈 0. 05 ）. Conclusion Alprostadil application during emergency PCI can improve myocardial microcirculation, decrease myocardial ischemia - reperfusion injuries by expanding coronary artery and anti - inflammatory, thus fir/ally improve the cardiac function of acute myocardial infarction patients.
出处
《实用心脑肺血管病杂志》
2015年第1期20-23,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
东莞市科技计划立项项目:冠脉超选择注射前列地尔对急诊PCI再灌注疗效观察(201310515000212)
关键词
心肌梗死
前列地尔
血管成形术
气囊
冠状动脉
心功能
Myocardial infarction
Alprostadil
Angioplasty, balloon, coronary
Heart function
