肾上腺素冠状动脉内给药对STEMI患者PCI术后无复流的影响  

Effects of intracoronary epinephrine on no-reflow phenomenon in STEMI patients after PCI

作　　者：陈立晗 王爱华 陈慧波 CHEN Lihan;WANG Aihua;CHEN Huibo(Department of Cardiology,Harbin Second Hospital,Harbin 150056,Heilongjiang,China)

机构地区：[1]哈尔滨市第二医院心内二科,黑龙江哈尔滨150056

出　　处：《中南医学科学杂志》2025年第2期249-252,共4页Medical Science Journal of Central South China

基　　金：黑龙江省卫生健康委科研项目(20230303010464)。

摘　　要：目的 探讨肾上腺素冠状动脉内给药对急性ST段抬高心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后冠状动脉无复流(NRP)的影响。方法 选择100例STEMI患者,随机均分为对照组(维拉帕米)和观察组(肾上腺素)。比较两组心肌灌注情况、心功能、心肌损伤标志物、恶性心律失常、NRP、短期预后等情况。结果 观察组TIMI 3级、TMPG 3级占比高于对照组,cTFC低于对照组(P<0.05)。与术前比较,术后两组左室舒张末内径、氨基末端脑钠肽前体、超敏C反应蛋白、心肌肌钙蛋白I、肌酸激酶同工酶、肌红蛋白、左室收缩末内径降低,左室射血分数升高;且观察组改善幅度大于对照组(P<0.05)。观察组恶性心率失常、NRP、重大心血管事件发生率低于对照组(P<0.05)。结论 肾上腺素冠状动脉内给药可改善STEMI患者PCI术后心肌灌注,降低NRP发生率,有利于短期预后。Aim To investigate the effects of intracoronary epinephrine administration on coronary no-reflow phenomenon(NRP) in patients with ST-segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI).Methods A total of 100 STEMI patients were randomly divided into control group(verapamil) and observation group(epinephrine),with 50 cases in each group.The two groups were compared in terms of myocardial perfusion,cardiac function,myocardial injury markers,malignant arrhythmia,NRP,and short-term prognosis.Results The proportion of TIMI grade 3 and TMPG grade 3 in observation group was higher than that in control group,while cTFC was lower than that in control group(P<0.05).Compared with the levels before operation,left ventricular end-diastolic diameter,N-terminal pro-brain natriuretic peptide,high-sensitivity C reactive protein,cardiac troponin I,creatine kinase-MB,myoglobin,and left ventricular end-systolic diameter were decreased and left ventricular ejection fraction was increased in both groups after operation.The improvement of observation group was greater than that of control group(P<0.05).The incidence of malignant arrhythmia,NRP and major cardiovascular events in the observation group was lower than that in the control group(P<0.05).Conclusion Intracoronary administration of epinephrine can improve myocardial perfusion,reduce the incidence of NRP,and benefit short-term prognosis in STEMI patients after PCI.

关 键 词：肾上腺素 急性ST段抬高心肌梗死 PCI 无复流现象 

分 类 号：R542.22[医药卫生—心血管疾病]