山莨菪碱联合硝酸甘油治疗急性ST段抬高型心肌梗死行PCI术后无复流患者的效果  

Effects of Anisodamine combined with Nitroglycerin in treatment of acute ST segment elevation myocardial infarction patients with no-reflow after PCI

作　　者：杨俊杰 YANG Junjie(Department of Cardiovascular Intensive Medicine of Zhumadian Central Hospital,Zhumadian 463000 Henan,China)

机构地区：[1]驻马店市中心医院心血管重症医学科,河南驻马店463000

出　　处：《中国民康医学》2023年第1期15-17,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察山莨菪碱联合硝酸甘油治疗急性ST段抬高型心肌梗死(STEMI)行经皮冠状动脉介入术(PCI)后无复流患者的效果。方法:回顾性分析2019年10月至2020年12月该院收治的72例STEMI行PCI术后无复流患者的临床资料,按照治疗方案不同将其分为对照组和观察组各36例。两组均行PCI治疗,术后无复流发生后,对照组予以硝酸甘油治疗,观察组在对照组基础上联合山莨菪碱治疗。比较两组心肌梗塞溶栓治疗(TIMI)血流分级3级占比、TIMI心肌灌注分级(TMPG)3级占比、PCI术后1 h心电图ST段回落率、手术前后炎性指标[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、细胞间黏附分子-1(ICAM-1)]水平和主要心血管不良事件发生率。结果:PCI术后,观察组TIMI血流分级3级占比、TMPG 3级占比和心电图ST段回落率均高于对照组,差异有统计学意义(P<0.05);观察组IL-6、hs-CRP和ICAM-1水平均低于对照组,差异有统计学意义(P<0.05);两组主要心血管不良事件发生率比较,差异无统计学意义(P>0.05)。结论:山莨菪碱联合硝酸甘油治疗STEMI行PCI术后无复流患者可改善心肌灌注,促进心电图ST段回落,降低炎性指标水平。Objective: To observe effects of Anisodamine combined with nitroglycerin in treatment of acute ST-segment elevation myocardial infarction(STEMI) patients with no-reflow after percutaneous coronary intervention(PCI). Methods: The clinical data of 72 STEMI patients with no-reflow after PCI admitted to the hospital from October 2019 to December 2020 were retrospectively analyzed. According to different treatment options, they were divided into control group and observation group, 36 cases in each. Both groups were treated with PCI. After no-reflow occurred, the control group was treated with Nitroglycerin, while the observation group was treated with Anisodamine on the basis of that of the control group. The proportion of thrombolysis in myocardial infarction(TIMI) blood flow grade 3, the proportion of TIMI myocardial perfusion grade(TMPG) 3, the ST-segment resolution rate 1 h after PCI, the levels of inflammatory indexes [interleukin-6(IL-6), high-sensitivity C-reactive protein(hs-CRP), intercellular adhesion molecule-1(ICAM-1)] before and after the surgery, and the incidence of major adverse cardiovascular events were compared between the two groups. Results: After PCI, the proportion of TIMI blood flow grade 3, the proportion of TMPG grade 3 and the ST segment resolution rate of ECG in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05). The levels of IL-6, hs-CRP and ICAM-1 in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). However, there was no significant difference in the incidence of major adverse cardiovascular events between the two groups(P>0.05). Conclusions: Anisodamine combined with Nitroglycerin in the treatment of the STEMI patients with no-reflow after PCI can increase the proportion of TIMI blood flow grade 3, the proportion of TMPG grade 3 and the ST segment resolution rate, and reduce the levels of inflammatory indexes. Moreover, it is superior to

关 键 词：山莨菪碱 硝酸甘油 急性ST段抬高型心肌梗死 经皮冠状动脉介入术 无复流 TIMI血流分级 心电图ST段 

分 类 号：R542.2[医药卫生—心血管疾病]