摘要
目的研究冠状动脉造影时冠状动脉内注射三磷酸腺苷和硝酸甘油治疗冠状动脉慢血流型心绞痛的即刻效果。方法选取于2010年4月至2013年6月就诊于山西医科大学第二临床医学院心血管内科以胸痛等心绞痛症状为主诉、冠状动脉造影证实心外膜主要冠状动脉无狭窄病变、前降支存在冠状动脉慢血流现象的患者56例,按简单随机化分组分为三磷酸腺苷组(31例)和硝酸甘油组(25例);选取年龄、性别、心血管危险因素匹配且冠状动脉造影完全正常的患者34例为对照组。在硝酸甘油组中选取冠状动脉注射硝酸甘油后TIMI帧计数(TFC)值仍大于50帧的患者11例作为双药组,对该组患者冠状动脉内已注射硝酸甘油造影后,再次冠状动脉内注射三磷酸腺苷40μg后重复造影。两组患者于造影后经造影导管冠状动脉内分别快速注入三磷酸腺苷40μg或硝酸甘油200μg后重复造影。在肝位记录前降支慢血流患者用药前后的TFC值和血流正常者的TFC值。结果基础TFC值在三磷酸腺苷组为76.3±20.6;硝酸甘油组为73.8±18.3;正常对照组为28.7±2.6。三磷酸腺苷组治疗后TFC值下降为26.3±3.2,与治疗前比较,差异有统计学意义(P<0.01);与对照组比较,差异无统计学意义(P>0.05)。硝酸甘油组治疗后TFC值下降为48.6±8.2,与治疗前比较,差异有统计学意义(P<0.01);与对照组比较升高,差异有统计学意义(P<0.05);三磷酸腺苷组治疗前后的TFC差值明显高于硝酸甘油组(P<0.05);双药组患者冠状动脉内注射硝酸甘油后造影,平均TFC值为56.6±6.2,对该组患者冠状动脉内再次注射三磷酸腺苷40μg后,TFC值降为26.6±4.7,与硝酸甘油治疗后比较,差异有统计学意义(P<0.01);与对照组比较,差异无统计学意义(P>0.05)。结论冠状动脉慢血流型心绞痛患者冠状动脉内注射三磷酸腺苷后,即刻冠状动脉血流可以恢复到正常水平,明显优于硝酸甘油。对硝酸甘�
Objective To assess the immediate efficacy of intracoronary adenosine triphosphate and nitroglycerin for patients with the coronary slow flow angina(CSFA).Methods Fifty-six patients with CSFA but without stenotic lesions during diagnostic coronary angiography from Department of Cardiology,the Second Hospital of Shanxi Medical University between April 2010 and June 2013 were enrolled and divided into the adenosine triphosphate group(n=31) and the nitroglycerin group(n=25),34 patients with normal coronary flow served as normal control.Intracoronary injection of 40 μg adenosine triphosphate or 200 μg nitroglycerin through the diagnostic catheter was applied to patients with CSFA to repeat coronary angiography.11 patients with thrombolysis in myocardial infarction frame count(TFC)>50 after used nitroglycerin in the nitroglycerin group were as the double medicine group,who were injected 40μg adenosine triphosphate again repeat angiography after intravascular injection of nitroglycerin angiography.Two groups of patients after angiography through the angiography of the coronary artery were quickly injected with 40 μg of adenosine triphosphate or 200 μg of nitroglycerin after repeated angiography.The coronary blood flow was evaluated by TFC method.Results The basic TFC of the adenosine triphosphate group,the nitroglycerin group and the normal control group were 76.3±20.6,73.8±18.3 and 73.8±18.3,respectively.In the adenosine triphosphate group,TFC reduced to 26.3±3.2 after treatment(compared with before treatment,P<0.01; compared with the normal control group,there was no significant difference,P>0.05).In the nitroglycerin group,TFC reduced to 48.6±8.2 after treatment(compared with before treatment,P<0.01; compared with the normal control group they were higher than the normal control group,P<0.05); In the adenosine triphosphate group,TFC had significantly greater than nitroglycerin group after treatment(P<0.05).In the double medicine group,TFC was 56.6±6.2 after injection of nitroglycerin,after intravascular i
出处
《中华临床医师杂志（电子版）》
CAS
2017年第5期734-737,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
心绞痛
血流速度
硝酸甘油
三磷酸腺苷
Angina pectoris
Blood flow velocity
Nitroglycerin
Adenosine triphosphate
