前列地尔对急性心肌梗死患者延迟PCI术后心肌灌注及心功能的影响  

Effect on Myocardial Perfusion and Heart Function of Patients with Acute Myocardial Infarction Treated by Delayed PCI with Alprostadil

作　　者：王治乾[1] 李远[2] 肖文良[1] 

机构地区：[1]河北医科大学第三医院心内科,河北省石家庄市050051 [2]石家庄市第四医院内科,河北省石家庄市050011

出　　处：《中国动脉硬化杂志》2014年第6期587-590,共4页Chinese Journal of Arteriosclerosis

基　　金：河北省医学重点研究课题(20090441)

摘　　要：目的采用^99m锝-甲氧基异丁基异腈（^99mTc-MIBI）门控静息心肌断层显像研究前列地尔对急性心肌梗死患者行延迟冠状动脉介入（PCI）治疗的疗效。方法选首次发病时间超过12h，未行溶栓治疗且无持续胸痛的急性心肌梗死患者60例，随机分组：对照组30例，常规药物治疗基础上于发病后7～14天行PCI治疗；前列地尔组30例，在以上治疗基础上给予前列地尔。两组于发病1周及治疗后12周行^99mTc-MIBI门控静息心肌断层显像，比较两组治疗前后左心室舒张期末容积（LVEDV）、左心室收缩期末容积（LVESV）、左心室射血分数（LVEF）、心肌缺血面积（IA）的变化。结果两组患者发病1周时的LVEDV、LVESV、LVEF及IA比较无统计学差异。治疗12周后前列地尔组LVEDV、LVESV较对照组明显下降，LVEF明显升高，IA明显缩小。结论前列地尔可明显改善急性心肌梗死延迟PCI患者心肌灌注以及恢复其心室功能。Aim To investigate the effect of alprostadil in the acute myocardial infarction （AMI） patients treated by delayed PCI with the 99mTc- methodxy isobutyl isomitrile （99mTc-MIBI） gated-myocardial perfusion stable image （G-MPI）. Methods 60 patients were enrolled. Patients had the first myocardial infarction beyond 12 hours without thrombolytic ther- apy. Patients were divided into control group （n = 30） and alprostadil group （n = 30） randomizedly. The control group were given conventional treatment and delayed PCI, while alprostadil group were treated by conventional treatment, delayed PCI and alprostadil. In all patients, G-MPI was received in the first week and the twelfth week after AMI. Then left ven- tricular end diastolic volume （ LVEDV）, left ventricular end systolic volume （ LVESV）, left ventricular ejection fraction （LVEF） and ischemic area （IA） were compared. Results LVEDV, LVESV, LVEF and IA between the two groups had no significant differences in the first week. After 12 weeks, LVEDV and LVESV of alprostadil group were significantly lower than those of control group, but LVEF of alprostadil group was significantly higher than that of control group. IA of al- prostadil group was significantly less than that of control group. Conclusion The effects of alprostadil and delayed PCI include complete revascularization, improvements in perfusion, faster restoration of ventricular function.

关 键 词：前列地尔 急性心肌梗死 延迟PCI 心肌灌注 心功能 ^99mTc-MIBI门控静息心肌断层显像 

分 类 号：R5[医药卫生—内科学]