冠脉内注射腺苷联合逆向精准溶栓对AMI患者心肌灌注及预后的影响研究  

Effect of Intracoronary Injection of Adenosine Combined with Reverse Precise Thrombolysis on Myocardial Perfusion and Prognosis in AMI

作　　者：兰芳[1] Lan Fang(Department of Geriatrics and Cardiology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州大学第一附属医院老年心血管科,河南郑州450000

出　　处：《黑龙江医学》2025年第6期643-646,共4页Heilongjiang Medical Journal

摘　　要：目的:观察冠脉内注射腺苷联合逆向精准溶栓对急性心肌梗死(AMI)患者心肌灌注及预后的影响。方法:选取2022年1月—2023年5月郑州大学第一附属医院收治的119例AMI患者作为研究对象,采用计算机随机分组法将其分为溶栓组(59例)和联合组(60例)。溶栓组实施逆向精准溶栓治疗,联合组在溶栓组治疗基础上联合经冠脉内注射腺苷配合治疗。比较两组患者心肌灌注、心肌损伤标志物水平变化及预后情况。结果:治疗后,联合组患者的心肌梗死溶栓治疗实验(TIMI)分级3级占比、TIMI心肌灌注分级(TMPG) 3级占比均高于溶栓组,差异均有统计学意义(χ^(2)=10.527、6.364,P<0.05);联合组患者TIMI血流帧数计数(e TFC)低于溶栓组,心肌灌注指数(PI)高于溶栓组,差异均有统计学意义(t=3.402、2.816,P<0.05);联合组患者肌红蛋白(MYO)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)低于溶栓组,差异均有统计学意义(t=2.691、4.008、2.787,P<0.05);联合组患者的不良预后发生率为6.67%,低于溶栓组患者的20.34%,差异有统计学意义(χ^(2)=4.778,P<0.05)。结论:冠脉内注射腺苷联合逆向精准溶栓治疗AMI能改善患者心肌灌注情况,减轻心肌损伤,对降低不良预后发生风险具有积极意义。Objective:To observe the effect of intracoronary injection of adenosine combined with reverse precise thrombolysis on myocardial perfusion and prognosis in AMI patients.Methods:119 patients with AMI were randomly divided into a thrombolysis group(59 cases)and a combination group(60 cases).The thrombolysis group received reverse precision thrombolysis treatment,while the combination group received coronary injection of adenosine in combination with thrombolysis treatment.The myocardial perfusion,changes in myocardial injury biomarker levels,and prognosis of the two groups of patients were compared.Results:Under different treatment regimens,the proportion of TIMI grade 3 and TMPG grade 3 in the combined group was higher than that in the thrombolysis group(χ^(2)=10.527,6.364;P<0.05).The TIMI frame rate count(eTFC)of the combined group was lower than that of the thrombolysis group,and the myocardial perfusion index(PI)was higher than that of the thrombolysis group(t=3.402,2.816;P<0.05).The levels of myoglobin(MYO),creatine kinase isoenzyme(CK-MB),and lactate dehydrogenase(LDH)in the combination group were lower than those in the thrombolysis group(t=2.691,4.008,2.787;P<0.05).The incidence of poor prognosis in the combination group was 6.67%,which was lower than 20.34%in the thrombolysis group,and the differences were statistically significant(χ^(2)=4.778,P<0.05).Conclusion:Coronary injection of adenosine combined with reverse precise thrombolysis can improve myocardial perfusion in AMI patients,alleviate myocardial injury,and reduce the risk of adverse prognosis.

关 键 词：急性心肌梗死 逆向精准溶栓 冠脉内注射腺苷 心肌灌注 预后情况 

分 类 号：R54[医药卫生—心血管疾病]