经微导管注射硝酸甘油治疗急性ST段抬高型心肌梗死冠脉介入术中无复流患者的1年随访结果：前瞻性随机对照研究  

One-Year Follow-Up of Nitroglycerin Injection by Microcatheter on No-Reflow during Percutaneous Coronary Intervention in patients with ST Segment Elevation Myocardial Infarction: A Randomized Control Study

作　　者：王新国 王成钢[1] 叶明[1] 祖晓麟[1] 王旭[1] 曾玉杰[1] WANG Xin-guo;WANG Cheng-gang;YE Ming;ZU Xiao-lin;WANG Xu;ZENG Yu-jie(Capital Medical University,Beijing Anzhen Hospital,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院

出　　处：《中国分子心脏病学杂志》2019年第5期3069-3072,共4页Molecular Cardiology of China

基　　金：北京市科委基金（Z161100000116073)

摘　　要：目的探讨经微导管注射硝酸甘油对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术中无复流的1年预后的影响。方法采用前瞻性随机对照研究设计,连续入选2016年7月至2017年12月在北京安贞医院行急诊PCI术中无复流发生的STEMI患者104例。采用随机数字表法,将患者分为试验组(经微导管注射硝酸甘油)和对照组(经指引导管注射硝酸甘油)。主要研究终点为随访期间发生主要心血管不良事件(包括心血管死亡率、再次心肌梗死及再次血运重建率)。结果两组随访期间临床用药无明显差别,微导管组术后1年(中位数374 d)随访期间发现主要心血管不良事件较对照组明显减少(1.9%vs 15.4%,P=0.03)。结论PCI术中经微导管注射硝酸甘油可能改善STEMI患者术中冠脉无复流的长期预后,减少主要心血管不良事件的发生。Objective To explore the long-term efficacy of nitroglycerin(NTG)injection by microcatheter in patients with ST segment elevation myocardial infarction(STEMI)and no-reflow during percutaneous coronary intervention(PCI).Methods A total of 104 subjects with STEMI and no-reflow during PCI were invited to participate the study and randomized to microcatheter group(NTG was injected using microcatheter)and guiding catheter group(NTG was injected using guiding catheter)from July 2016 to December 2017 at Beijing Anzhen Hospital.The primary endpoint of the study was major adverse cardiovascular events(MACEs,including cardiovascular mortality,recurrent myocardial infarction and target vessel revascularization)during a follow up of one year.Results There is no significant difference in clinical medicine treatment between the two groups during the follow up of one year(median 374 d).A significant lower incidence of MACEs(1.9%vs 15.4%,P=0.03)was documented in the microcatheter group as compared with that in the guiding catheter group.Conclusion NTG injection by microcatheter may decrease the MACEs including mortality,recurrent myocardial infarction and vessel revascularization in patients with STEMI and no-reflow during PCI.

关 键 词：ST段抬高型急性心肌梗死 冠状动脉介入治疗 无复流 硝酸甘油 微导管 

分 类 号：R54[医药卫生—心血管疾病]