摘要
目的探讨ACS患者在直接经皮冠状动脉介入治疗过程中,对无复流现象进行防治时,尼可地尔的应用时机。方法依据不同的尼可地尔应用时机,选取168例行直接经皮冠状动脉介入治疗的ACS患者,根据随机数字表法分为2组,每组各84例,均为冠脉内给药,一组为置入支架前预防性给药组,另一组为置入支架后发生无复流现象时补救性给药组;支架置入完成后,造影观察及比较罪犯血管血流TIMI、TMPG及MBG分级和无复流现象的发生率等指标。结果支架置入完成后,罪犯血管血流TIMI、TMPG及MBG分级均达到3级的患者比例,预防性给药组为91.7%,补救性给药组为76.2%,差异有统计学意义(P <0.05);罪犯血管无复流现象的发生率,预防性给药组为8.3%,补救性给药组为23.8%,差异有统计学意义(P <0.05);所有出现无复流现象的患者,冠脉内给予尼可地尔治疗后,均恢复TIMI、TMPG、MBG分级3级血流。结论对于适宜的ACS患者,行直接经皮冠状动脉介入治疗时,支架置入前冠脉内给予尼可地尔治疗,能够明显降低支架置入后无复流现象的发生率。
Objective To investigate the timing of the application of nicoradil for preventing and controlling the phenomenon of no reflow during the Primary percutaneous coronary intervention process in ACS patients. Method Depending on the time of application of nicodil, 168 patients with ACS with routine PPCI were selected, they were divided into 2 groups according to the random number table method, there were 84 cases in each group, all were given intravascularly, one group received prophylactic administration before stent placement, the other group was the salvage administration group with no refiow after stent implantation;after stent implantation, the TIMI, TMPG and MBG grades of blood flow and the incidence of no reflow were observed and compared. Results After stent implantation, the proportion of patients with grade 3 blood flow grade TIMI, TMPG and MBG in Culprit vessel,the prophylactic group was 91.7%, the remedial administration group was 76.2%, there were statistical differences(P < 0.05);no reflow of blood vessels in Culprit vessel, the prophylactic group was 8.3%, the remedial administration group was 23.8%, there were statistical differences(P < 0.05);all patients presented with no reflow, after intravascular treatment with nicodil, TIMI, TMPG and MBG grade 3 blood flow was restored.Conclusion For appropriate ACS patients, when the line PPCI, treatment with nicodil was given before stent implantation, it can significantly reduce the incidence of no reflow after stent implantation.
作者
赖碁
光雪峰
茹志刚
林霄峰
景舒南
方杰
LAI Qi;GUANG Xue-feng;RU Zhi-gang;LIN Xiao-feng;JING Shu-nan;FANG Jie(Dept.of Cardiology,Yan'an Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650051,China)
出处
《昆明医科大学学报》
CAS
2019年第12期61-65,共5页
Journal of Kunming Medical University
基金
国家自然科学基金资助项目(81360037)
关键词
急性冠脉综合征
无复流现象
尼可地尔
直接经皮冠状动脉介入治疗
应用时机
Acute coronary syndrome
Primary percutaneous coronary intervention(PPCI)
No reflow phenomenon
Nicoradil
Application time
