联合用药的缺血后适应对急性心肌梗死介入治疗的疗效探讨  

Effect of combined ischemic postconditioning on interventional therapy for acute myocardial infarction

作　　者：程俊[1] 宋慧琴 谢丽娟[1] 宋雯雯[1] 骆嵩山 CHENG Jun1,SONG Hui-qin2,XIE Li-juan3,SONG Wen-wen3,LUO Song-shan3(1.Guangdong Province,Yingde people＇s Hospital of cardiovascular medicine,Guangdong,Qingyuan 513000,China;2.Guangdong Province Yingde City People＇s Hospital of the elderly,Guangdong Qingyuan 513000,China;3.Guangdong Province Yingde City People＇s Hospital Cardiovascular Medicine,Guangdong Qingyuan 513000,Chin)

机构地区：[1]广东省英德市人民医院心血管内科,广东清远513000 [2]广东省英德市人民医院老年科,广东清远513000

出　　处：《中西医结合心血管病电子杂志》2018年第9期57-59,共3页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨联合用药的缺血后适应(IPoC)对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)的疗效影响。方法选取2014年4月~2017年12月我院急诊科收治的接受PCI治疗的AMI患者360例为研究对象。根据IPoC冠脉注入替罗非班和硝普钠的方式不同分为对照组和观察组,180例对照组患者按照常规操作给予替罗非班和硝普钠,180例观察组患者给药后用球囊堵住冠脉。对比两组患者临床疗效,分析两组患者不良反应发生情况。结果对照组治疗总有效率为90.00%,观察组治疗总有效率为97.22%,观察组明显高于对照组,两组患者临床疗效差异具有统计学意义(P<0.05)。两组患者治疗后出现不同程度的血压下降、微量出血等PCI治疗的AMI患者常见不良反应。对照组总不良反应发生率12.23%(22/180),明显高于观察组的3.33%(6/180),两组患者不良反应发生情况差异具有统计学意义(P<0.05)。结论给予替罗非班和硝普钠后用球囊堵住冠脉相比常规操作的IPoC对AMI经PCI治疗的疗效显著,不良反应降低。Objective To investigate the combination of ischemic postconditioning（IPo C） on acute myocardial infarction（AMI） in patients with percutaneous coronary intervention（PCI） the clinical effects.Methods We selected 360 patients with AMI who received emergency PCI treatment in our emergency department from April 2014 to December 2017.According to the IPo C of intracoronary injection of tirofiban and sodium nitroprusside were divided into control group and observation group,180 cases of control group were routinely given tirofiban and sodium nitroprusside were administered to 180 patients,patients in the observation group after balloon blocked coronary artery.The clinical efficacy of the two groups was compared.The adverse reactions of two groups were analyzed.Results The total effective rate of the control group was 90%,the total effective rate of the observation group was 97.50%,the observation group was significantly higher than that of the control group,the difference between the two groups of clinical efficacy was statistically significant（P〈0.05）.Two groups of patients with different levels of blood pressure drop,micro bleeding and other AMI treatment of PCI patients common complications.The incidence of total adverse reactions in the control group was 12.23%（22/180）,which was significantly higher than that of the observation group 3.33%（6/180）.The total complication rate of the control group was 11%（22/200）,the total complication rate of the observation group was 3%（6/200）,and the difference of the adverse reactions between the two groups was statistically significant（P〈0.05）.Conclusion Compared with routine operation,IPo C is significantly effective in the treatment of AMI with PCI after tirofiban and nitroprusside and the incidence of adverse reactions is decreased.

关 键 词：缺血后适应 急性心肌梗死 介入治疗 替罗非班 硝普钠 

分 类 号：R542.22[医药卫生—心血管疾病]