硝普钠联合肾上腺素冠脉内注射治疗急诊PCl冠脉慢血流疗效  

Therapeutic effect of sodium nitroprusside combined with adrenaline on coronary artery slow blood flow in emergency PCl

作　　者：李绍华[1] 陈丽丹 陈德俊[1] 赖汉齐[1] LI Shao-hua(Department of Cardiology,Puning Overseas Chinese Hospital,Puning 515300,China)

机构地区：[1]普宁华侨医院心血管内科,广东普宁515300

出　　处：《牡丹江医学院学报》2019年第2期67-69,87,共4页Journal of Mudanjiang Medical University

基　　金：揭阳市科技计划项目(2017YL029)

摘　　要：目的对比观察硝普钠联合肾上腺素冠脉内注射治疗急诊PCl冠脉慢血流疗效。方法将我院住院行急诊PCI并出现慢血流的84例ACS患者按随机序列表分为A组(硝普钠联合肾上腺组)、B组(硝普钠)两组,两组患者在10mL替罗非班冠脉内注射的基础上,A组患者行硝普钠200μg+肾上腺素100μg冠脉内注射,B组行硝普钠200μg冠脉内注射。对比观察两组血流等级、校正的TIMI计帧数(CTFC)、术后左心室射血分数(LVEF)和左室舒张末期内径,以及术中并发症和术后60d内不良事件的发生情况。结果 A组治疗后的左心室射血分数(LVEF)显著高于B组,CTFC水平、左室舒张末期内径显著低于B组,差异具有统计学意义(P<0.05)。而两组治疗前后TIMI3级血流比例、治疗前的CTFC水平差异均无统计学意义(P>0.05)。A组术中并发症的发生率显著低于B组(P<0.05),其中低血压的发生率显著低于B组,而出血、血小板减少症的发生率两组间差异均无统计学意义(P>0.05)。结论与单纯硝普钠相比,硝普钠联合肾上腺素冠脉内注射可有效治疗急诊PCl冠脉慢血流的发生,降低低血压的发生率,具有较大的临床应用意义。Objective To compare the efficacy of sodium nitroprusside combined with adrenaline in the treatment of chronic PC1 coronary flow.Methods Eighty-four patients with ACS who underwent emergency PCI and slow blood flow in our hospital were randomly divided into group A (sodium nitroprusside combined with adrenal group) and group B (sodium nitroprusside).The two groups were in 10 mL.On the basis of intracoronary injection of tirofiban, patients in group A were given 100 μg of sodium nitroprusside plus epinephrine with intracoronary injection, and patients in group B were given 200 μg sodium nitroprusside with intracoronary injection.Contrast observation of blood flow grade, corrected TIMI frame number (CTFC), postoperative left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter, as well as intraoperative complications and adverse events within 60 days after surgery .Results The left ventricular ejection fraction (LVEF) of group A was significantly higher than that of group B.The CTFC level and left ventricular end diastolic diameter were significantly lower than those of group B ( P <0.05).There was no significant difference in the ratio of TIMI grade 3 blood flow and CTFC before treatment between the two groups ( P >0.05).The incidence of intraoperative complications in group A was significantly lower than that in group B ( P <0.05).The incidence of hypotension was significantly lower than that in group B, and the incidence of hemorrhage and thrombocytopenia was not statistically significant.( P >0.05).Conclusion Compared with simple sodium nitroprusside, intraperitoneal injection of sodium nitroprusside combined with adrenaline can effectively treat the occurrence of chronic slow blood flow in the emergency PC1 and reduce the incidence of hypotension.It has great clinical significance.

关 键 词：硝普钠 肾上腺素 慢血流 急性心梗 冠脉内注射 

分 类 号：R541.4[医药卫生—心血管疾病]