不同剂量多巴胺降低急诊经皮冠状动脉介入术患者心肌再灌注损伤的效果比较  

Application Value of Different Doses of Dopamine in Reducing Myocardial Reperfusion Injury and Reperfusion Arrhythmia in Patients with Acute Inferior Myocardial Infarction Undergoing Emergency PCI

作　　者：万玲 罗萍[2] 黄晓飞 黄骞[1] WAN Ling;LUO Ping;HUANG Xiaofei;HUANG Qian(Yongcheng People's Hospital,Yongcheng Henan 476600,China;Henan Provincial People's Hospital,Zhengzhou Henan 450003,China)

机构地区：[1]永城市人民医院,河南永城476600 [2]河南省人民医院,河南郑州450003

出　　处：《药品评价》2022年第9期557-560,共4页Drug Evaluation

摘　　要：目的:探讨经皮冠状动脉介入治疗(PCI)的急性下壁心肌梗死患者应用不同剂量多巴胺的效果及对其心肌再灌注损伤及再灌注心律失常的影响。方法:随机数字表法将2019年10月至2021年12月间永城市人民医院收治的87例急性下壁心肌梗死PCI患者分为2组,43例对照组患者接受阿托品联合常规5 mg多巴胺治疗,44例研究组患者给予阿托品联合小剂量2 mg多巴胺,观察各组患者行急诊PCI 72 h后临床效果,PCI前、后心肌损伤相关指标水平,PCI前和24 h心功能水平以及再灌注心律失常等不良事件发生情况。结果:研究组总有效率84.09%(37/44),对照组总有效率79.07%(34/43),两组差异无统计学意义(P>0.05);研究组PCI后ST段回落幅度高于对照组,肌酸激酶同工酶、肌钙蛋白Ⅰ低于对照组(P<0.05);研究组患者PCI后24 h LVESD、LVEDD均小于对照组,LVEF高于对照组(P<0.05),研究组患者临时植入起搏器及心室颤动发生率均低于对照组(P<0.05),无复流发生率两组差异无统计学意义(P>0.05)。结论:急性下壁心肌梗死PCI患者使用阿托品联合小剂量多巴胺治疗可较常规剂量有效改善心肌再灌注损伤和心功能,降低再灌注心律失常的发生,效果确切。Objective:To investigate the effect of different doses of dopamine on myocardial reperfusion injury and reperfusion arrhythmia in patients with acute inferior myocardial infarction treated by percutaneous coronary intervention(PCI).Methods:87 patients with acute inferior myocardial infarction undergoing PCI in Yongcheng People's Hospital from October 2019 to December 2021 were randomly divided into two groups.43 patients in the control group were treated with atropine combined with conventional 5 mg dopamine,and 44 patients in the study group were treated with atropine combined with low-dose 2 mg dopamine.The clinical effects 72 h after emergency PCI were observed.The level of myocardial injury related indexes,the level of cardiac function before and at the end of 2W after PCI,and the occurrence of adverse events such as reperfusion arrhythmia.Results:The total effective rate was 84.09%(37/44)in the study group and 79.07%(34/43)in the control group.There was no significant difference between the two groups(P>0.05);In the study group,the decline of ST segment after PCI was higher than that in the control group,and the isozymes of creatine kinase and troponin I were lower than those in the control group(P<0.05);At the end of 24 h after PCI,LVESD and LVEDD in the study group were lower than those in the control group,and LVEF was higher than that in the control group(P<0.05).The incidence of temporary pacemaker implantation and ventricular fibrillation in the study group were lower than those in the control group(P<0.05).There was no significant difference between the two groups(P>0.05).Conclusion:Atropine combined with low-dose dopamine can effectively improve myocardial reperfusion injury and cardiac function and reduce the incidence of reperfusion arrhythmia in patients with acute inferior myocardial infarction after PCI.

关 键 词：下壁心肌梗死 经皮冠状动脉介入治疗 多巴胺 心肌再灌注损伤 心律失常 

分 类 号：R542.22[医药卫生—心血管疾病]