冠脉内应用肾上腺素对急性心肌梗死并心源性休克患者冠脉血流及心肌灌注的影响  

Effects of Intracoronary Epinephrine on Coronary Blood Flow and Myocardial Perfusion in Patients with Acute Myocardial Infarction Complicated with Cardiogenic Shock

作　　者：周拥志[1] 彭筱平[1] 夏小鹏[1] 任玉钢 潘政荣 ZHOU Yong-zhi;PENG Xiao-ping;XIA Xiao-peng;REN Yu-gang;PAN Zheng-rong(Department of Cardiovascular Medicine,The First Affiliated Hospital of Hunan Traditional Chinese Medical College(Hunan Province Directly Affiliated TCM Hospital),Zhuzhou,Hunan,412000,China)

机构地区：[1]湖南中医药高等专科学校附属第一医院(湖南省直中医医院)心血管内科,湖南株洲412000

出　　处：《现代生物医学进展》2025年第4期656-662,共7页Progress in Modern Biomedicine

基　　金：湖南中医药大学校级科研基金项目(2022XYLH203)。

摘　　要：目的:观察冠脉内应用肾上腺素对急性心肌梗死并心源性休克(AMICS)患者冠脉血流及心肌灌注的影响.方法:采用随机数字表法将我院2023年1月~2024年6月期间收治的AMICS患者84例分为对照组[n=42,经皮冠状动脉介入术(PCI)治疗]和观察组(n=42,对照组基础上于冠脉内注射肾上腺素).对比两组用药前、用药后平均动脉压、心率、术中心律失常发生率、TIMI血流分级、心肌灌注呈色分级、N末端B型钠尿肽前体(NT-ProBNP)、左心室射血分数(LVEF)、住院期间主要不良心血管事件发生情况.结果:观察组用药后平均动脉压、LVEF高于对照组,心率、NT-ProBNP低于对照组(P<0.05).两组用药后TIMI血流分级、心肌灌注呈色分级有所改善,且观察组优于对照组(P<0.05).观察组的术中心律失常发生率、住院期间主要不良心血管事件发生率低于对照组(P<0.05).结论:冠脉内应用肾上腺素应用于AMICS患者,可有效稳定平均动脉压、心率,降低术中心律失常发生率和主要不良心血管事件发生率,改善冠脉血流及心肌灌注.Objective:To observe the effects of intracoronary epinephrine on coronary blood flow and myocardial perfusion in patients with acute myocardial infarction complicated with cardiogenic shock(AMICS).Methods:A total of 84 AMICS patients who were admitted to our hospital from January 2023 to June 2024 were selected,they were divided into control group[n=42,percutaneous coronary intervention(PCI)]and observation group(n=42,intracoronary epinephrine injection on the basis of the control group)according to random number table method.The mean arterial pressure,heart rate,incidence of central arrhythmia during surgery,TIMI blood flow classification,color classification of myocardial perfusion,N-terminal B-type natriuretic peptide precursor(NT-ProBNP),left ventricular ejection fraction(LVEF),and incidence of major adverse cardiovascular events during hospitalization were compared between the two groups before and after medication.Results:The mean arterial pressure,LVEF were higher than those of control group,heart rate,NT-ProBNP of observation group after medication were lower than those of control group(P<0.05).TIMI blood flow classification,color classification of myocardial perfusion were improved in both groups,and the observation group was better than that of the control group(P<0.05).The incidence of central arrhythmia during surgery,incidence of major adverse cardiovascular events of the observation group were lower than those of the control group(P<0.05).Conclusion:Intracoronary epinephrine can effectively stabilize mean arterial pressure and heart rate in patients with AMICS,reduce the incidence of central arrhythmia during surgery and major adverse cardiovascular events,and improve coronary blood flow and myocardial perfusion.

关 键 词：肾上腺素 急性心肌梗死 心源性休克 冠脉血流 心肌灌注 

分 类 号：R3[医药卫生—基础医学] R542.22