药物干预冠状动脉介入治疗术中无复流、慢血流的疗效分析.pdfVIP

《中国医学前沿杂志 （电子版）》2012年第4卷第10期 ● 临床研究● 63 药物干预冠状动脉介入治疗术中无复流、 慢血流的疗效分析 张辉锋，董平栓，王可，杨旭明，王绍欣，李志娟，王红雷，邢适颖 （河南科技大学第一附属医院　心 内科，洛阳　471003） 【摘要】　 目的　观察硝酸甘油、地尔硫 、硝普钠、替罗非班对冠状动脉介入中无复流、慢血流 现象的治疗效果。方法　冠状动脉介入术中出现无复流、慢血流现象118例，依次给予硝酸甘油、 地尔硫 、硝普钠、替罗非班观察靶血管前向血流的心肌梗死溶栓试验血流分级 （thrombolysis in myocardial infarction ，TIMI ）。结果　硝普钠、替罗非班能明显改善TIMI血流，治疗无复流现象的有 效率优于硝酸甘油和地尔硫 ，差异有显著性。进一步的亚组分析中发现，在ST段抬高的急性冠状动 脉综合征 （acute coronary syndrome ，ACS ）中，替罗非班优于硝普钠，在非ST段抬高的ACS中，硝 普钠优于替罗非班，差异有显著性。结论　硝普钠和替罗非班对冠状动脉介入术中慢血流及无复流现 象有确切疗效。 【关键词】　硝酸甘油；地尔硫 ；硝普钠；替罗非班；冠状动脉介入治疗；无复流、慢血流现象 Effects of various drugs in patients with no refl ow/ slow refl ow during PCI procedure ZHANG Hui-feng, DONG Ping-shuan, WANG Ke, YANG Xu-ming, WANG Shao-xin, LI Zhi-juan, WANG Hong-lei, XING Shi-ying (The First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, China) Corresponding author: DONG Ping-shuan, Email: dongpingshuan@163.com Abstract Objectives To observe the various drugs in patients with no refl ow/ slow refl ow during PCI 【 】 procure. Methods One hundred-eighten cases of no refl ow/ slow refl ow patients during PCI procure were infused with nitroglycerin, diltiazem, sodium nitroprusside, tirofi ban by turns, and the target vessel TIMI fl ow was graded accordingly. Results Sodium nitroprusside, tirofi ban improve target vessel TIMI low signifi cantly than nitroglycerin and diltiazem (than nitroglycerin and diltiazem (than nitroglycerin and diltiazem (PP ＜0.01). Conclusions Sodium nitroprusside, tirofi ban had defi nite effect in patients with no refl ow/ slow refl ow during PCI procure. Key words Nitroglycerin Diltiazem Sodium nitroprusside Tirofiban Percutaneous coronary 【 】 ； ； ； ； interventions No refl ow/ slow refl ow phenomenon. ； [1] 心肌无复流现象在1974年由Kloner等 提出。