冠脈內(nèi)聯(lián)合注射罌粟堿和替羅非班對(duì)PCI術(shù)中無(wú)復(fù)流的療效觀察
發(fā)布時(shí)間：2019-01-30 14:53
【摘要】：為了評(píng)價(jià)PCI中冠狀動(dòng)脈內(nèi)聯(lián)合應(yīng)用罌粟堿及替羅非班與維拉帕米及替羅非班對(duì)急性心肌梗死無(wú)復(fù)流的療效及安全性。選擇2014年1月~2016年7月筆者所在科室收治的急性ST段抬高心肌梗死行急診PCI,梗死相關(guān)動(dòng)脈開通后無(wú)復(fù)流患者108例,隨機(jī)分為觀察組和對(duì)照組各54例。兩組患者手術(shù)方法相同,出現(xiàn)無(wú)復(fù)流現(xiàn)象后給予替羅非班,觀察組給予罌粟堿,對(duì)照組給予維拉帕米。觀察兩組注射藥物后無(wú)復(fù)流恢復(fù)時(shí)間、TMPG分級(jí)、術(shù)后1小時(shí)心電圖ST段回落、左心功能及住院期間的主要心血管事件。觀察組無(wú)復(fù)流恢復(fù)時(shí)間、TIMI血流分級(jí)、TMPG分級(jí)、心電圖ST段回落、左室射血分?jǐn)?shù)均優(yōu)于對(duì)照組(P0.05),觀察組住院期間的MACE發(fā)生率低于對(duì)照組(P0.05)。研究表明AMI行急診PCI出現(xiàn)無(wú)復(fù)流給予罌粟堿和替羅非班,可以增加STEMI患者PCI術(shù)中發(fā)生無(wú)復(fù)流現(xiàn)象后冠狀動(dòng)脈血流和心肌組織灌注,減少術(shù)后心絞痛及MACE的發(fā)生率,且未增加圍手術(shù)期不良事件的發(fā)生。
[Abstract]:To evaluate the efficacy and safety of combined intracoronary administration of papaverine, tirofiban, verapamil and tirofiban in the treatment of acute myocardial infarction without reflow in PCI. From January 2014 to July 2016, 108 patients with acute ST segment elevation myocardial infarction were randomly divided into two groups: observation group (n = 54) and control group (n = 54). The two groups were treated with tirofiban after no reflow, the observation group with papaverine and the control group with verapamil. No reflow recovery time, TMPG grade, ST segment fall 1 hour after injection, left ventricular function and main cardiovascular events during hospitalization were observed in the two groups. No reflow recovery time, TIMI blood flow grading, TMPG grading, ECG ST segment drop, left ventricular ejection fraction were better than the control group (P0.05), the incidence of MACE during hospitalization in the observation group was lower than that in the control group (P0.05). The results showed that the occurrence of no reflow of papaverine and tirofiban in emergency PCI with AMI could increase coronary blood flow and myocardial perfusion after PCI in STEMI patients, and reduce the incidence of angina pectoris and MACE. The incidence of adverse events in perioperative period was not increased.
【作者單位】： 大連市友誼醫(yī)院心內(nèi)科;
【基金】：2016年北京力生心血管健康基金會(huì)領(lǐng)航基金項(xiàng)目(LHJJ201611007)
【分類號(hào)】：R542.22
，
本文編號(hào)：2418245
[Abstract]:To evaluate the efficacy and safety of combined intracoronary administration of papaverine, tirofiban, verapamil and tirofiban in the treatment of acute myocardial infarction without reflow in PCI. From January 2014 to July 2016, 108 patients with acute ST segment elevation myocardial infarction were randomly divided into two groups: observation group (n = 54) and control group (n = 54). The two groups were treated with tirofiban after no reflow, the observation group with papaverine and the control group with verapamil. No reflow recovery time, TMPG grade, ST segment fall 1 hour after injection, left ventricular function and main cardiovascular events during hospitalization were observed in the two groups. No reflow recovery time, TIMI blood flow grading, TMPG grading, ECG ST segment drop, left ventricular ejection fraction were better than the control group (P0.05), the incidence of MACE during hospitalization in the observation group was lower than that in the control group (P0.05). The results showed that the occurrence of no reflow of papaverine and tirofiban in emergency PCI with AMI could increase coronary blood flow and myocardial perfusion after PCI in STEMI patients, and reduce the incidence of angina pectoris and MACE. The incidence of adverse events in perioperative period was not increased.
【作者單位】： 大連市友誼醫(yī)院心內(nèi)科;
【基金】：2016年北京力生心血管健康基金會(huì)領(lǐng)航基金項(xiàng)目(LHJJ201611007)
【分類號(hào)】：R542.22
，
本文編號(hào)：2418245
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