直接PTCA联合Lipo—PGE1对糖尿病并急性心肌梗死的心功能保护作用  

Clinical observations of immediate PTCA combined with Lipo-PGE1 for acute myocardial infarction with diabetic patients

作　　者：郭舜奇[1] 陈平[1] 蔡志雄[1] 朱稚丹[1] 周厚仕[1] 潘盛青[1] 林浩[1] 王文亮[1] 

机构地区：[1]广东省汕头市中心医院心内科,515031

出　　处：《中国医师进修杂志》2007年第7期14-16,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价经皮冠状动脉腔内成形术（PTCA）联合脂微球载体前列腺素E1（Lipo-PGE1）治疗糖尿病并急性心肌梗死（AMI）的心功能保护作用。方法将84例拟行PTCA治疗的糖尿病合并AMI患者采用配对分组，单纯PTCA组仅行传统治疗和直接PTCA治疗，联合治疗组在单纯PTCA组治疗的基础上联合应用Lipo—PGE1，分别观察两组患者手术成功率和心功能变化情况。结果84例患者中，梗死相关血管再通81例，成功率为96．4％。联合治疗组梗死相关血管再通41例，成功率为97．6％，术后30min心电图显示ST段下降较单纯PTCA组明显，24h心功能改善显著，随诊半年临床心功能和左室射血分数（LVEF）较单纯PTCA组明显改善，差异有统计学意义。结论直接PTCA联合Lipo—PGE1治疗糖尿病并AMI疗效较单纯直接PTCA者佳，无明显不良反应，能较好地保护患者心功能。Objective To explore the protected effect of immediate percutaneous transluminal coronary angioplasty （PTCA）combined with liposomal prostaglandin E1 （Lipo-PGE1） on the treatment of acute myocardial infarction （AMI）with diabetic patients. Methods Eighty-four diabetic patients with AMI who prepare for immediate PTCA were divided into two groups. The cases were given traditional way and immediate PTCA in pure PICA group, and Lipo-PGE1 was given to the therapeutic alliance group on the base of PTCA group. Then it was observed their successful rate and the change of cardiac function. Results The obstructed blood vessels were re-opened in 81 cases,and the successful rate was 96.4%. In therapeutic alliance group obstructed blood vessels were re-opened in 41 cases, and the successful rate was 97.6%. The ST segments on ECG 30 minutes after operations descended more significantly, the clinical cardiac function and left ventricular ejection fraction （LVEF） were also improved more significantly 24 hours after operations in therapeutic alliance group than those in PTCA group. So were those 6 months after operations. Conclusion The immediate PTCA combined with Lipo-PGE1 for diabetic patients with AMI shows a better therapy effect, no side effect and can protect cardiac function better.

关 键 词：经皮冠状动脉腔内成形术 脂微球载体前列腺素E 糖尿病 心肌梗死 

分 类 号：R587[医药卫生—内分泌] R542[医药卫生—内科学]