小剂量多巴胺用于急诊PCI中对AIMI患者治疗效果的影响  

Influence of low dose dopamine on therapeutic effects of emergency percutaneous coronary intervention for patients with acute inferior myocardial infarction

作　　者：陈旭华 姜雯 CHEN Xuhua;JIANG Wen(Department of Emergency,Minghua Hospital,Nanjing 210000,China)

机构地区：[1]南京明基医院急诊科,江苏南京210000

出　　处：《中国急救复苏与灾害医学杂志》2020年第11期1235-1238,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家自然科学基金项目(编号:81970605)。

摘　　要：目的研究小剂量多巴胺用于急诊经皮冠状动脉介入治疗(PCI)中对急性下壁心肌梗死(AIMI)患者治疗效果的影响。方法纳入2018年2月-2020年2月于南京明基医院收治的100例行急诊PCI治疗的AIMI患者为研究对象,按照随机数表法分为两组,各50例,其中对照组接受常规术前治疗并行急诊PCI,观察组在对照组基础上于急诊冠状动脉造影结束后给予小剂量多巴胺(2 mg)联合阿托品0.5 mg静脉注射。比较两组治疗疗效,观察两组治疗前及治疗后1周心功能指标肌钙蛋白I、ST段回落幅度、肌酸激酶同工酶及左心室射血分数,分析两组急诊PCI情况。结果观察组治疗有效率为76.00%,对照组治疗有效率为72.00%,差异无统计学意义(P>0.05)。两组急诊PCI治疗后肌钙蛋白I、ST段回落幅度、肌酸激酶同工酶较治疗前均显著下降(P<0.05),左心室射血分教较治疗前显著上升(P<0.05);观察组治疗后肌钙蛋白I、ST段回落幅度、肌酸激酶同工酶显著低于对照组(P<0.05),左心室射血分数显著高于对照组(P<0.05)。两组应用替罗非班率、植入支架率及冠状动脉再通率比较差异无统计学意义(P>0.05)。观察组术中心室颤动率、无复流率、植入临时起搏器率显著低于对照组(P<0.05)。结论小剂量多巴胺用于急诊PCI中可保护AIMI患者心功能,有效减少临时起搏器置入、室颤及无复流发生。Objective To study the influence of low dose dopamine on therapeutic effects of emergency percutaneous coronary intervention(PCI)for patients with acute inferior myocardial infarction(AIMI)Methods 100 patients with AIMI undergoing percutaneous transluminal coronary intervention(PCI)in the emergency room were randomly divided into 2 equal groups:control group'receiving routine preoperative treatment and observation group given 2 mg dopamine combined with atropine 0.5 mg by intravenous injection in addition.The therapeutic effects of the two groups were compared,The cardiac function indexes,such as cardiac troponin I,ST segment falling range,creatine kinase isoenzyme and left ventricular ejection fraction,were observed before and 1 week after treatment in the two groups,and the emergency PCI situation in the two groups was analyzed.Results The effective rate of the observation group was 76.00%,not significantly different from that of the control group(72.00%,P>0.05).I week after treatment,the levels of troponin I and creatine kinase isoenzyme levels and extent of STR were all significantly lower than those before treatment;and the LVEF was significantly higher than that before treatment(all P<0.05)for these 2 groups.The troponin I and creatine kinase isoenzyme levels 1 week after treatment of the observation group were all significantly lower than those of the control group(all P<0.05);and the LVEF 1 week treatment of the observation group was significantly higher than that of the control group.There was no significant difference in the tirofiban use rate,stent implantation rate,and recanalization rate between these 2 groups(all P>0.05).The left ventricular fibrillation rate,no reflow rate,and temporary pacemaker implantation rate of the observation group were all significantly lower than those in the control group(all P<0.05).Conclusion Low dose dopamine helps protect the cardiac function of the AIMI patients undergoing emergency PCI,and effectively reduce the incidence of temporary pacemaker implanta tion,ventric

关 键 词：急性下壁心肌梗死 经皮冠状动脉介入治疗 多巴胺 左心室射血分数 

分 类 号：R542.22[医药卫生—心血管疾病]