前列地尔对急性冠脉综合症择期冠脉介入治疗心肌灌注及心功能的影响被引量：4

Effects of alprostadil on myocardial ischemia-reperfusion and cardiac function of patients with acute coronary syndromes undergoing delayed percutaneous coronary intervention

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摘要目的:探讨静脉应用前列地尔注射液(凯时)对急性冠脉综合症(ACS)患者行择期冠状动介入治疗(择期PCI)时心肌微循环灌注及左心室功能的影响。方法:选择2013年05月至2015年05月我院心内科住院治疗的择期PCI ACS患者98例,采用单纯随机抽样法将其分为观察组52例(前列地尔+标准治疗)和对照组46例(标准治疗),1周后均行冠状动脉造影及PCI治疗。比较两组患者择期冠脉造影TIMI血流水平分级、PCI术后校正的TIMI血流帧数(CTFC)、入院时和PCI术后1、3、6、12月左心室功能指标(血浆NT pro BNP、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)。结果:观察组冠状动脉造影病变血管(IRA)TIMI血流分级水平优于对照组,差异具有统计学意义(P<0.05);且择期PCI术后观察组IRA CTFC明显低于对照组(P<0.01);入院时及PCI术后1、3月反映左心功能指标NT pro BNP、LVEF、LVEDD、LVESD两组比较无统计学差异(P>0.05);而术后6、12月反映左心功能各项指标观察组明显优于对照组(P<0.05,P<0.01)。结论:急性冠脉综合症患者静脉应用前列地尔注射液可以明显改善择期PCI术前冠状动脉TIMI血流及术后心肌微循环灌注,改善后期左心室功能,为临床应用提供参考价值。 Objective： To explore the effects of alprostadil on cardiac function and myocardial ischemia-reperfusion of patients with acute coronary syndromes（ACS） undergoing delayed percutaneous coronary intervention（PCI）. Methods： 98 patients with ACS diagnosed by clinical features were investigated consecutively and randomized into routine therapy group（n = 46） and alprostadil therapy group（n = 52）. All patients were given coronary artery angiograph and PCI after one week. The degree of TIMI flow, corrected TIMI frame count（CTFC）after PCI, concentrations of plasma amino terminal pro brain natriuretic peptide（NT pro BNP）, LVEF, LVEDD,and LVESD examined on admission and at 1, 3, 6, and 12 months after delayed PCI were compared and analyzed.Results： TIMI flow in alprostadil therapy group was better than that in control group before delayed PCI（P〈0.05）. CTFC after delayed PCI in the alprostadil therapy group was significantly better than that in control group（P〈0.01）. The similar NT pro BNP, LVEF, LVEDD, and LVESD on admission and at 1 and 3 months after delayed PCI were observed in both groups（P〉0.05）, but significantly better in alprostadil therapy group at 6 and12 months after delayed PCI（P〈0.01 and P〈0.05 respectively）. Conclusion： Early administration of alprostadil in patients with acute coronary syndromes undergoing delayed percutaneous coronary intervention improves myocardial reperfusion and the prognosis of left ventricular function, and reduces the occurrence of slow-flow.

作者林文果刘丽何江肖祥彬黄大岗

机构地区宜宾市第二人民医院心内科

出处《泸州医学院学报》 2015年第6期563-566,共4页 Journal of Luzhou Medical College

关键词急性冠脉综合症前列地尔心功能冠状动脉介入治疗心肌微循环 Acute coronary syndrome Alprostadil Left ventricular function Percutaneous coronary intervention Myocardial reperfusion

分类号 R541.4 [医药卫生—心血管疾病]

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