硝普钠处理急性心肌梗死经皮冠状动脉介入治疗中无复流现象的临床疗效和安全性  

Clinical efficacy and safety of nitroprusside disposed no-reflow phenomenon for patients with acute myocardial infarction during percutaneous coronary intervention

作　　者：简立国[1] 刘士超[1] 丁同斌[1] 赵江涛[1] 程栋[1] 

机构地区：[1]郑州大学第二附属医院心内科,郑州450014

出　　处：《郑州大学学报（医学版）》2014年第6期848-852,共5页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:评价硝普钠处理急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)中无复流现象的临床疗效和安全性。方法:选择PCI术中出现无复流现象的72例AMI患者为研究对象,分为硝普钠组36例和硝酸甘油组36例。针对PCI术中出现的无复流现象,两组经微导管向冠状动脉病变远端分别迅速注入硝普钠或硝酸甘油,10 min后行冠状动脉造影进行靶血管TIMI血流分级;比较两组术中和术后24 h血压、术后30 d内主要不良心血管事件(MACE)发生情况及超声心动图测定的左室射血分数(LVEF)和左室舒张末内径(LVEDD)。结果:两组TIMI靶血管血流分级差异无统计学意义(P=0.262);术中和术后24 h血压均未出现较大幅度变化(P>0.05);术后30 d内两组MACE发生率差异无统计学意义(P>0.05);术后30 d硝普钠组LVEF、LVEDD均优于硝酸甘油组(t=2.330、4.908,P<0.05)。结论:经微导管向冠状动脉病变远端注入硝普钠可有效处理在AMI患者PCI术中出现的无复流现象,安全易行。Aim：To evaluate the clinical efficacy and safety of nitroprusside disposed no-reflow phenomenon for patients with acute myocardial infarction（AMI） during percutaneous coronary intervention（PCI）.Methods：A total of 72 patients with AMI who had no-reflow phenomenon during PCI treatment were divided into nitroprusside group（n=36） and nitroglycerin group （n=36）.Nitroprusside or nitroprusside was rapidly injected into the distal coronary artery lesions through micro catheter , and 10 min later, TIMI flow grade was assessed by coronary angiography.Blood pressure of intraoperative and 24 h after operation, ma-jor adverse cardiovascular events（MACE） incidence and the cardiac function（LVEF and LVEDD） in the first thirty days after PCI were compared between the two groups.Results：There was no significant difference in TIMI flow grade （P=0.262） and MACE incidence （ P〉0.05） between the two groups; intraoperative and postoperative blood pressure were not significantly changed（P〉0.05）.LVEF and LVEDD were higher in nitroprusside group（t=2.330,4.908,P〈0.05）.Conclusion：Nitroprus-side could effectively dispose no-reflow phenomenon in patients with AMI during PCI, and is safe and easy.

关 键 词：硝普钠 急性心肌梗死 经皮冠状动脉介入治疗 无复流 

分 类 号：R541.1[医药卫生—心血管疾病]