急诊PCI院前应用肝素增加梗死相关动脉早期再灌注  

Prehospital application of heparin in emergency PCI increases early reperfusion of infarction related artery

作　　者：陈浩 周建华[2] 王超 CHEN Hao;ZHOU Jianhua;WANG Chao(Clinical Medical College,Weifang Medical University,Weifang,Shandong,261042,China;Department of Cardiology,Weihai Central Hospital Affiliated to Weifang Medical University)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261042 [2]潍坊医学院附属威海市中心医院心内科

出　　处：《临床心血管病杂志》2020年第11期991-993,共3页Journal of Clinical Cardiology

摘　　要：目的:探讨急诊冠状动脉介入(PCI)院前应用肝素对梗死相关动脉(IRA)早期再灌注的影响。方法:入选2019年10月—2020年5月在我院行急诊冠状动脉造影(CAG)的急性ST段抬高型心肌梗死(STEMI)患者96例,分为观察组(入院前给予肝素处理)和对照组(入院后给予肝素),各48例。通过CAG结果,分析冠状动脉血管病变情况,评价两组心肌梗死溶栓治疗临床试验(TIMI)血流、IRA再通情况。结果:两组IRA及病变血管比较差异无统计学意义(P>0.05)。观察组术前肝素作用时间(给予肝素至CAG时间)明显长于对照组[(78.13±7.76) min∶(16.15±2.66) min],两组肝素使用剂量无差异(均为100 U/kg)。两组前向TIMI血流分级、IRA再通比例有差异,观察组高于对照组(39.6%∶18.8%),差异有统计学意义(P=0.025)。结论:急诊PCI院前应用肝素可改善急性STEMI患者前向TIMI血流,增加IRA早期再灌注。Objective: To investigate the effect of the prehospital application of heparin in emergency PCI on early reperfusion of infarction related artery. Method: The 96 acute STEMI patients received emergency coronary angiography in hospital from 2019-10 to 2020-05 were divided into observation group(heparin treatment was given before hospital) and control group(heparin treatment was given after hospital), with 48 cases in each group. The coronary artery lesions were analyzed by coronary angiography results, and the thrombolysis in myocardial infarction blood flow grading and infarction related artery(IRA) recanalization were evaluated in the two groups. Result: IRA and coronary arteries showed no statistical significance(P>0.05). The heparin action time before PCI of the observation group was significantly longer than that of the control group[(78.13±7.76) min vs(16.15±2.66) min], and there was no difference in heparin dose between the two groups(both were 100 U/kg). There were significant differences in forward TIMI blood flow grading and recanalization between the two groups, and the observation group was higher than the control group(39.6% vs 18.8%), with statistically significant differences(P=0.025). Conclusion: Prehospital application of heparin in emergency PCI can improve forward TIMI flow and increase early reperfusion of IRA in patients with acute STEMI.

关 键 词：早期再灌注 急性ST段抬高型心肌梗死 梗死相关血管 肝素 

分 类 号：R542.22[医药卫生—心血管疾病]