合贝爽在急性冠脉综合征介入治疗中对无复流、心功能及炎性因子的影响  

The effect of Herbesser on no reflow,cardial function and inflammation factors in acute coronary syndrome patients who are undergoing PCI

作　　者：陈章强[1] 洪浪[1] 姚民[2] 

机构地区：[1]江西省人民医院心内科,南昌330006 [2]中国医学科学院阜外心血管病医院

出　　处：《临床心血管病杂志》2015年第7期721-724,共4页Journal of Clinical Cardiology

摘　　要：目的：探讨合贝爽在急性冠状动脉综合征（ACS）介入治疗中对无复流、心功能以及炎性因子的影响。方法：选取行介入治疗（PCI）出现无复流的ACS患者60例,完全随机分为合贝爽组（A组）和硝酸甘油组（B组）各30例。A组术中经微导管选择性冠脉靶病变远端注射法给予合贝爽200-600μg;B组术中同样方法从冠脉内给予硝酸甘油200-600μg,观察给药10-20min后冠脉心肌梗死溶栓试验血流（TIMI）分级和校正的TIMI血流帧数（CTFC）、术后1周和30d血浆高敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、细胞间黏附分子（ICAM-1）和前体脑钠肽（NT-proBNP）的水平变化以及心脏结构和功能的变化,观察术后30d内心血管事件发生率。结果：两组患者用药后TIMI血流分级和CTFC均有明显改善,但A组较B组血流恢复更好（P〈0.05）。两组血压水平差异无统计学意义。两组20min后心率有统计学差异（P〈0.05）。与B组比较,A组术后1周及术后30dLVESD、LVEDD均明显下降,LVEF明显增加（均P〈0.05）。另外,两组治疗1周和30d后,NTproBNP、hs-CRP、IL-6、ICAM-1水平均明显下降（均P〈0.01）,A组较B组下降更为明显（均P〈0.05）。两组在再发心肌梗死、恶性心律失常及心源性死亡方面差异无统计学意义,但两组再发心绞痛、心力衰竭发生率有统计学差异（均P〈0.05）。结论：合贝爽在ACS介入治疗中能减少无血流现象,使无复流恢复到TIMI 3级血流,明显减少心血管事件的发生率,明显优于硝酸甘油。Objective：To explore the effect of Herbesser on no reflow,cardial function and inflammation factors in acute coronary syndrome patients who are undergoing percutaneous coronary intervention（PCI）.Method：Sixty patients who received PCI treatment with no-reflow phenomenon were enrolled and randomly divided into Herbesser group（group A,n=30）and Nitroglycerin group（group B,n=30）.The patients in group A were given Herbesser 200-600μg with injection from micro-catheter selective coronary to distal target lesions,and the patients in group B were given Nitroglycerin 200-600μg in the same way from the coronary.Coronary Thrombolysis in Myocardial Infarction（TIMI）flow grade and corrected TIMI frame count（CTFC）after 10-20 minutes of drug administration were observed.In addition,the following factors were observed on the 7th day and on the 30 th day after procedure：the plasma levels of high-sensitivity C-reactive protein（hs-CRP）,interleukin-6（IL-6）,intercellular adhesion molecule（ICAM-1）,the precursor of brain natriuretic peptide（NT-proBNP）,and heart construction and function changes.The incidence of cardiovascular events was observed after thirty days.Result：The TIMI blood flow grade and CTFC were significantly improved in the two group after treatment,while the blood flow recovered better in group A than that in group B（P〈0.05）.The blood pressure levels of the two groups appeared to have no significant difference,while heart rate appeared to have significant difference after 20 mins of drug administration（P〈0.05）.After one week and thirty days of PCI,left ventricular end-systolic dimension（LVESD）,left ventricular end-diasystolic dimension（LVEDD）,and left ventricular eject factor（LVEF）all decreased visibly（all P〈0.05）,while LVEF value increased obviously（P〈0.05）.In addition,the patient＇s plasma levels of NT-proBNP,hs-CRP,IL-6,and ICAM-1decreased significantly（all P〈0.01）-after treatment of one week and thirty days;all parameters above de

关 键 词：急性冠状动脉综合征 合贝爽 经皮冠状动脉介入治疗 无复流 心功能 炎性因子 

分 类 号：R541.4[医药卫生—心血管疾病]