冠状动脉慢血流患者冠状动脉内注射前列地尔和硝酸甘油的即刻效果对比  

Comparison of the immediate effect of intracoronary alprostadil injection and nitroglycerin injection in patients with coronary slow flow

作　　者：张和细 彭飞 史益军 龚辉 ZHANG Hexi;PENG Fei;SHI Yijun;GONG Hui(Department of Cardiology,Jinshan Hospital of Fudan University,Shanghai 201508,China)

机构地区：[1]复旦大学附属金山医院心内科,上海市201508

出　　处：《中国动脉硬化杂志》2023年第7期612-616,共5页Chinese Journal of Arteriosclerosis

基　　金：上海市金山区卫生健康委员会课题(JSKJ-KTMS-2021-08);上海市卫生健康委员会课题(20214Y0367)。

摘　　要：[目的]研究并比较冠状动脉内注射前列地尔与硝酸甘油治疗冠状动脉慢血流的即刻效果。[方法]选取102例冠状动脉造影无明显狭窄的患者,其中冠状动脉慢血流65例,对照组37例。慢血流患者根据冠状动脉内注射药物不同分为硝酸甘油组(32例)和前列地尔组(33例)。比较三组临床基线资料及冠状动脉TIMI血流帧数(TFC值),以及前列地尔组与硝酸甘油组TFC下降值。[结果]三组临床基线资料除吸烟(P=0.02)外,差异均无显著性。注射药物前,前列地尔组和硝酸甘油组左前降支(LAD)、回旋支(LCX)、右冠状动脉(RCA)三支冠状动脉TFC值均较对照组显著升高(P<0.05),而前列地尔组与硝酸甘油组三支冠状动脉TFC值差异无显著性(P>0.05);注射药物后,前列地尔组和硝酸甘油组LAD、LCX、RCA三支冠状动脉TFC值均较注射药物前显著下降(P<0.05),且前列地尔组LAD、LCX、RCA三支冠状动脉TFC下降值分别为硝酸甘油组TFC下降值的5.51、3.51、2.78倍(P<0.01);前列地尔组注射药物后三支冠状动脉TFC值与对照组相比差异无统计学意义(P>0.05)。[结论]冠状动脉内注射前列地尔或硝酸甘油均能即刻显著改善冠状动脉慢血流TFC值,且前列地尔效果优于硝酸甘油。Aim To investigate and compare the immediate effect of intracoronary alprostadil and nitroglycerin injection in the treatment of coronary slow flow.Methods A total of 102 patients without obvious coronary angiography stenosis were selected,including 65 patients with coronary slow flow and 37 patients in the control group.Patients with slow flow were divided into nitroglycerin group(32 cases)and alprostadil group(33 cases)according to intracoronary drug injection.Baseline clinical data,coronary TIMI flow frames(TFC values),and TFC declines between the alprostadil group and nitroglycerin group were compared.Results There was no significant difference in baseline clinical data among the three groups except smoking(P=0.02).Before injection,TFC values of the left anterior descending branch(LAD),circumflex branch(LCX)and right coronary artery(RCA)were significantly increased in alprostadil group and nitroglycerin group compared with control group(P<0.05),but there was no significant difference in TFC values of the three coronary arteries between alprostadil group and nitroglycerin group(P>0.05).After injection,the TFC values of LAD,LCX and RCA were significantly decreased in three coronary arteries in alprostadil group and nitroglycerin group compared with those before injection(P<0.05).The decreased values of LAD,LCX and RCA in alprostadil group were 5.51,3.51 and 2.78 times of those in nitroglycerin group,respectively(P<0.01).There was no significant difference in three coronary artery TFC values between the alprostadil group and the control group(P>0.05).Conclusion Intracoronary injection of alprostadil or nitroglycerin can immediately improve coronary slow flow TFC value,and the effect of alprostadil is better than that of nitroglycerin.

关 键 词：冠状动脉慢血流 前列地尔 硝酸甘油 

分 类 号：R541.4[医药卫生—心血管疾病]