磷酸肌酸对经皮冠状动脉介入术后患者左心功能和预后的影响  

Effects of creatine phosphate on left ventricular function and prognosis of patients undergoing precutaneouscoronary intervention

作　　者：蔡建生[1] 彭志坚[1] 章少波[1] 李继锋[1] 洪奋玲 

机构地区：[1]汕头市第二人民医院心内科,广东省汕头515011

出　　处：《中国基层医药》2013年第23期3524-3526,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：基金项目：广东省汕头市重点科技计划项目（201063）

摘　　要：目的探讨经皮冠状动脉介入术（PCI）围术期应用磷酸肌酸对左心功能及预后的影响。方法80例心绞痛患者按数字表法随机分为治疗组（n=40）和对照组（n=40），治疗组在常规治疗的基础上，PCI术前后采用磷酸肌酸注射液静脉滴注。治疗前及治疗后6个月行心脏超声检查测量计算左室射血分数（LVEF）、二尖瓣舒张早期充盈E峰速率（E），二尖瓣舒张晚期充盈速率（A），E峰速率／A峰速率（E／A）。并随访主要心血管事件发生率。结果治疗后，两组左室射血分数优于治疗前（t=-3．59、-2．13，均P〈0．05），且治疗组优于对照组（t=2．02，P〈0．05）。两组治疗后E峰、A峰、E／A均优于治疗前（t=-11．87、-16．80、16．79、24．28、-17．58、-28．61，均P〈0．01），治疗组较对照组更明显（t=3．82、-3．13、4．44，均P〈0．05）。随访6个月，治疗组发生复合心血管事件较对照组少且差异有统计学意义（X2=4．11，P〈0．05）。结论PCI围术期应用磷酸肌酸能改善心脏的能量代谢状态，更好地维护了心脏功能并改善预后。Objective To evaluate the effects of perioperative application of exogenous creatine phosphate on left ventricular function and prognosis of patients undergoing percutaneous coronary intervention（PCI）. Methods 80 patients with angina pectoris were randomly divided into treatment group（ n = 40 ） and control group（ n = 40 ）. 40 pa- tients in the treatment group received intravenous infusion of creatine phosphate injection before and after PCI based on the conventional therapy. Before treatment and after treatment for 6 months, cardiac ultrasound was used to measure left ventricular ejection fraction（ LVEF）, mitral valve of early diastolic filling E peak rate （E）, late diastolic mitral valve filling rate（A） ,the ratio of E peak rate to A peak rate（E/A）. And the incidence rate of the major cardiovascu- lar events was observed. Results 6 months after treatment, the LVEF was significantly improved in two groups （ t = -3.59, -2.13, all P 〈 0.01 ） , and the difference between the two groups was statistically significant （t = 2.02, P 〈 0.05 ）. Indexes of left ventricular diastolic function （ E, A, E/A） were significantly improved after treatment （ t = - 11.87, - 16.80,16.79,24.28, - 17.58, -28.61, all P 〈 0.01 ）, the differences between the two groups were signif- icant（ t = 3.82, - 3.13,4.44, all P 〈 0.05 ）. The patients were followed up for 6 months, the incidence rate of com- bined cardiovascular events in treatment group was significantly lower than that in the control group （ X2 = 4.11, P 〈 0.05 ）. Conclusion Application of creatine phosphate during the perioperative period of PCI can improve cardiac en- ergy metabolism, better maintenance of cardiac function and improve prognosis.

关 键 词：冠状动脉疾病 经皮冠状动脉介入治疗 磷酸肌酸 左心功能 预后 

分 类 号：R541.4[医药卫生—心血管疾病]