冠状动脉内注射硝普钠与硝酸甘油在急性心肌梗死急诊手术中的临床对照研究

发布时间：2018-11-15 08:38

【摘要】：目的:观察急性心肌梗死患者急诊冠状动脉介入治疗(PCI)中冠状动脉内给予硝普钠或冠状动脉内给予硝酸甘油的临床疗效。方法:将急性ST段抬高型心肌梗死的患者152例随机分为硝普钠组(78例)和硝酸甘油组(74例),常规治疗的基础上,冠状动脉内分别注射硝普钠或硝酸甘油,PCI后行冠状动脉造影检查,观察其TIMI血流分级及ST段50%回落率,并观察患者住院期间及术后6个月内的心血管事件发生率,作为评价指标。结果:2组患者临床基本指标比较无统计学差异(P0.05);慢血流与无复流的发生率硝酸甘油组高于硝普钠组(P0.05);PCI后6个月随访示硝普钠组与硝酸甘油组患者左室射血分数、左室舒张末直径以及心脏不良事件发生率比较,均差异有统计学意义(P0.05)。结论:PCI中冠状动脉内给予硝普钠较硝酸甘油可明显改善冠状动脉慢血流或无复流,对于急性心肌梗死患者可改善术后即刻血流,减少远期临床事件。
[Abstract]:Objective: to observe the clinical effect of acute myocardial infarction patients treated with sodium nitroprusside or intracoronary nitroglycerin in (PCI). Methods: 152 patients with acute ST segment elevation myocardial infarction were randomly divided into sodium nitroprusside group (78 cases) and nitroglycerin group (74 cases). Coronary arteriography was performed after PCI to observe the TIMI blood flow grade and the rate of 50% reduction of ST segment. The incidence of cardiovascular events during hospitalization and 6 months after operation was also observed as an index of evaluation. Results: there was no statistical difference between the two groups (P0.05), the incidence of slow blood flow and no reflow in nitroglycerin group was higher than that in sodium nitroprusside group (P0.05). Six months after PCI follow-up showed that there were significant differences in left ventricular ejection fraction left ventricular end-diastolic diameter and incidence of cardiac adverse events between sodium nitroprusside group and nitroglycerin group (P0.05). Conclusion: compared with nitroglycerin, sodium nitroprusside in PCI can significantly improve the slow flow or no reflow of coronary artery, and can improve the blood flow immediately after operation and reduce the long-term clinical events in patients with acute myocardial infarction.
【作者单位】：厦门大学附属第一医院心血管内科;
【分类号】：R542.22

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