冠状动脉内注射腺苷对急性心肌梗死再灌注后无复流的影响  

Effect of intracoronary injections of adenosine on no-reflow after reperfusion in acute myocardial infarction

作　　者：李丹[1] 王祖锦[1] 王岚峰[1] 杨树森[1] 周立君[1] 修春红[1] 潘薇[1] 李竹琴[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心内科,黑龙江哈尔滨150001

出　　处：《心脏杂志》2009年第3期371-374,共4页Chinese Heart Journal

基　　金：黑龙江省攻关课题项目资助(GC05C40302)

摘　　要：目的评价冠状动脉内注射腺苷对急性心肌梗死(AMI)再灌注治疗后无复流的影响。方法共62例行经皮冠状动脉介入治疗(PCI)的AMI患者,被随机分为对照组和腺苷组。以PCI后最终冠脉造影校正的心肌梗死溶栓试验血流帧数(corrected thrombolysis in myocardial infarction frame count,cTFC)为标准,当cTFC≥23时诊断为无复流。PCI前、后采集肘静脉血检测肌酸激酶同工酶(CK-MB)和超敏C反应蛋白(hsCRP)。比较两组无复流发生率及血浆心肌酶和炎症因子的变化。结果腺苷组中无复流的发生率较对照组明显降低(P<0.05)。腺苷组CK-MB和hsCRP较对照组明显降低(P<0.05)。多元线性回归分析显示CK-MB、hsCRP与无复流显著相关(P<0.05)。结论AMI患者冠脉内应用腺苷能有效降低无复流的发生,降低血浆心肌酶、炎症因子水平。AIM To evaluate the effect of intracoronary injections of adenosine on no-reflow after reperfusion in patients with acute myocardial infarction. METHORDS A total 62 patients treated with PCI were randomly divided into normal group and adenosine group. Corrected thrombolysis in myocardial infarction frame count （eTFC） post-PCI was taken as the criterion and no-reflow was set at cTFC ~〉23. Before and after PCI, CK-MB and hsCRP were detected and the incidence of no-reflow and the changes of plasma myocardial enzyme and inflammation factors in the two groups were compared. RESULTS The incidence of no-reflow in the adenosine group was obviously lower than that in the normal group （ P 〈 0. 05）. CK-MB and hs-CRP in the normal group was higher than those in the adenosine group （P 〈 0.05）. Multivariate line regression analysis showed a prominent correlation between the no-reflow and CK-MB and hsCRP （P 〈 0. 05）. CONCLUSION The intracoronary injections of adenosine in patients with AMI effectively decreases no-fellow and the levels of myocardial enzyme and inflammation factors.

关 键 词：腺苷 心肌梗死 急性 无复流 

分 类 号：R541.4[医药卫生—心血管疾病]