前列地尔脂微球注射液治疗急诊冠状动脉介入术患者的临床研究  

Clinical study of alprostadil injection in the treatment of patients with emergency percutaneous coronary intervention

作　　者：乔锐[1] 王明伟[1] 

机构地区：[1]安徽医科大学附属安庆医院心内科,246003

出　　处：《中国医师进修杂志》2013年第33期26-29,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 研究前列地尔脂微球注射液治疗急诊经皮冠状动脉介入治疗（PCI）患者的临床疗效.方法 选择接受急诊PCI的急性心肌梗死（AMI）患者85例,按就诊顺序采用随机、平行对照试验原则分为治疗组（45例）和对照组（40例）.所有患者术前给予阿司匹林300 mg,氯吡格雷300 mg,术后均长期给予抗血小板聚集和调脂等冠心病二级预防治疗,治疗组在常规治疗基础上给予0.9％氯化钠注射液100 ml加前列地尔脂微球注射液10μg静脉滴注,2次/d,疗程14 d.并分别于治疗后1、6个月做心脏彩超了解心功能及收缩功能,同时采用酶联免疫吸附试验法测定高敏C反应蛋白（hs-CRP）、内皮素（ET）-1及白细胞介素（IL）-6浓度,以比色法测定一氧化氮（NO）水平.对比分析两组急诊PCI治疗的情况,分析其临床特点、炎性标志物、住院期间及远期严重心血管不良事件（MACE）的发生情况.结果 两组治疗前、治疗后1个月IL-6、hs-CRP、ET-1、NO比较差异无统计学意义（P＞0.05）;治疗组治疗后6个月IL-6、hs-CRP、ET-1、NO与对照组比较差异有统计学意义[（1.04±1.10） ng/L比（3.82±1.34） ng/L、（1.5±1.2） mg/L比（3.5±0.8）mg/L、（62.18±20.22） ng/L比（85.56±16.55） ng/L、（55.25±8.25）μmol/L比（46.16±9.20）μmol/L]（P＜ 0.05）.两组治疗前、治疗后1个月左心室收缩末期容积（LVESV）、左心室舒张末期容积（LVEDV）、左心室射血分数（LVEF）比较差异无统计学意义（P＞0.05）;治疗组治疗后6个月LVESV和LVEDV小于对照组[（82.5±20.6） ml比（90.5±20.1） ml、（130.5±33.8）ml比（144.3±28.6） ml],LVEF高于对照组[（57.8±6.3）％比（48.5±6.5）％],差异有统计学意义（P＜0.05）.对照组病死率和累积总MACE发生率分别为7.5％（3/40）、25.0％ （10/40）,显著高于治疗组的4.4％ （2/45）、13.3％（6/45）,差异有统计学意义（P＜0.05）.对照组术后心力�Objective To research the clinical efficacy of alprostadil injection in treatment of patients with emergency percutaneous coronary intervention （PCI）.Methods Eighty-five patients with acute myocardial infarction（AMI） were enrolled in this study,and they were randomly divided into treatment group （45 patients） and control group （40 patients）.All patients were given 300 mg aspirin and 300 mg clopidogrel before operation,anti-platelet aggregation and long-term hpid regulation were given.On the basisof conventional treatment,0.9％ sodium chloride （NaCl） 100 ml and alprostadil injection 10 μ g were given in treatment group,2 times one day,a total of 14 d.After treatment for 1,6 months,the heart function and systohc function were assessed by echocardiography.High sensitive C reactive protein （hs-CRP）,endothehn （ET）-1 and interleukin （IL）-6 were measured with ELISA,nitric oxide （NO） was measured with chromatometry.The basic clinical characteristic,inflammatory markers and major adverse cardiac events （MACE） were analyzed during in-hospital and follow-up period between two groups.Results The level of IL-6,hs-CRP,ET-1,NO in two groups had no significant difference before treatment and after treatment for 1 month （P ＞ 0.05）.After treatment for 6 months,the level of IL-6,hs-CRP,ET-1,NO in treatment group had significant difference compared with that in control group [（1.04 ± 1.10） ng/L vs.（3.82 ± 1.34） ng/L,（1.5 ±1.2）mg/Lvs.（3.5 ±0.8） mg/L,（62.18 ± 20.22） ng/L vs.（85.56± 16.55） ng/L,（55.25 ± 8.25） μmol/L vs.（46.16 ±9.20） μ mol/L] （P ＜0.05）.The level of left ventricular end-systolic volume （LVESV）,left ventricular end-diastolic volume （LVEDV）,left ventricular ejection fraction （LVEF） in two groups before treatment and after treatment for 1 month had no significant difference （P ＞ 0.05）.After treatment for 6months,the level of LVESV,LVEDV in treatment group were significandy lower than those in control group [（8

关 键 词：前列地尔 心室功能 左 超声心动描记术 经皮冠状动脉介入 急性心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]