冠状动脉内应用硝酸甘油和尼可地尔对其血流缓慢的效果  

EFFECT OF INTRACORONARY APPLICATION OF NITROGLYCERIN OR NICORANDIL IN TREATMENT OF CORONARY SLOW FLOW

作　　者：修泽波 刘兴同 霍学震 李姗[5] 赵文娜 陈作元[1] XIU Zebo;LIU Xingtong;HUO Xuezhen;LI Shah;ZHAO Wenna;CHEN Zuoyuan(Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Chin)

机构地区：[1]青岛大学附属医院心血管内科,山东青岛266003 [2]聊城市人民医院心血管内科 [3]青岛市李村街道社区卫生服务中心 [4]德州市人民医院心血管内科 [5]青岛大学附属医院黄岛院区心血管内科 [6]青岛市第三人民医院心血管内科

出　　处：《青岛大学医学院学报》2017年第5期575-579,共5页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨冠状动脉内应用硝酸甘油和尼可地尔对冠状动脉慢血流现象的影响。方法因胸痛行冠状动脉造影证实心外膜主要冠状动脉血管无狭窄病变但血流缓慢病人60例,随机分为硝酸甘油组和尼可地尔组,各30例。两组经造影导管冠状动脉内分别给予硝酸甘油或尼可地尔,30s后重复造影。以TIMI帧计数(TFC)法定量评价病人的冠状动脉血流,并比较两组病人用药前后的心率、收缩压、舒张压、TFC值。结果硝酸甘油组用药后收缩压、舒张压较用药前明显降低,心率增加,左前降支、左回旋支、右冠状动脉TFC值均减少,差异均有显著性(t=8.310~18.371,P<0.01)。尼可地尔组用药后收缩压、舒张压、心率较用药前无明显变化(P>0.05),左前降支、左回旋支、右冠状动脉TFC值显著变小,差异有显著性(t=10.274~28.164,P<0.01)。尼可地尔组左前降支、左回旋支、右冠状动脉用药前后TFC值减少值的百分数大于硝酸甘油组,差异有显著性(t=8.146~12.181,P<0.01)。结论冠状动脉血流缓慢病人冠状动脉内注射尼可地尔的即刻治疗效果优于硝酸甘油。Objective To investigate the effect of intracoronary application of nitroglycerin or nicorandil in the treatment of coronary slow flow（CSF）.Methods A total of 60 CSF patients without stenotic lesions in major coronary arteries in the epicardium on coronary angiography performed due to chest pain were enrolled and randomly divided into nitroglycerin group and nicorandil group,with 30 patients in each group.Coronary angiography was performed before and at 30 seconds after the intracoronary administration of nitroglycerin or nicorandil.Coronary blood flow was evaluated by the thrombolysis in myocardial infarction（TIMI）frame count（TFC）method,and the two groups were compared in terms of heart rate,systolic and diastolic blood pressure,and TFC before and after administration.Results After the administration of nitroglycerin,the nitroglycerin group had significant reductions in systolic and diastolic blood pressure,a significant increase in heart rate,and significant reductions in TFCs of the left anterior descending branch,the left circumflex artery,and the right coronary artery（t=8.310-18.371,P〈0.01）.After the administration of nicorandil,the nicorandil group had no significant changes in systolic and diastolic blood pressure and heart rate,while it had significant reductions in TFCs of the left anterior descending branch,the left circumflex artery,and the right coronary artery（t=10.274-28.164,P〈0.01）.The nicorandil group had significantly greater reductions in TFCs of the left anterior descending branch,the left circumflex artery,and the right coronary artery compared with the nitroglycerin group（t=8.146-12.181,P〈0.01）.Conclusion In patients with CSF,intracoronary injection of nicorandil has a better immediate effect than nitroglycerin.

关 键 词：慢血流 冠状血管 注射 动脉内 尼可地尔 硝酸甘油 

分 类 号：R54[医药卫生—心血管疾病]