CAJ | 학술논문

目的：评价硝普钠处理急性心肌梗死（AMI）经皮冠状动脉介入治疗（PCI）中无复流现象的临床疗效和安全性。方法：选择PCI术中出现无复流现象的72例AMI患者为研究对象，分为硝普钠组36例和硝酸甘油组36例。针对PCI术中出现的无复流现象，两组经微导管向冠状动脉病变远端分别迅速注入硝普钠或硝酸甘油，10 min后行冠状动脉造影进行靶血管TIMI血流分级；比较两组术中和术后24 h血压、术后30 d内主要不良心血管事件（MACE）发生情况及超声心动图测定的左室射血分数（LVEF）和左室舒张末内径（LVEDD）。结果：两组TIMI靶血管血流分级差异无统计学意义（P ＝0．262）；术中和术后24 h 血压均未出现较大幅度变化（P ＞0．05）；术后30 d 内两组MACE 发生率差异无统计学意义（P ＞0．05）；术后30 d 硝普钠组LVEF、LVEDD 均优于硝酸甘油组（t ＝2．330、4．908，P ＜0．05）。结论：经微导管向冠状动脉病变远端注入硝普钠可有效处理在AMI 患者PCI 术中出现的无复流现象，安全易行。
목적：평개초보납처리급성심기경사（AMI）경피관상동맥개입치료（PCI）중무복류현상적림상료효화안전성。방법：선택PCI술중출현무복류현상적72례AMI환자위연구대상，분위초보납조36례화초산감유조36례。침대PCI술중출현적무복류현상，량조경미도관향관상동맥병변원단분별신속주입초보납혹초산감유，10 min후행관상동맥조영진행파혈관TIMI혈류분급；비교량조술중화술후24 h혈압、술후30 d내주요불양심혈관사건（MACE）발생정황급초성심동도측정적좌실사혈분수（LVEF）화좌실서장말내경（LVEDD）。결과：량조TIMI파혈관혈류분급차이무통계학의의（P ＝0．262）；술중화술후24 h 혈압균미출현교대폭도변화（P ＞0．05）；술후30 d 내량조MACE 발생솔차이무통계학의의（P ＞0．05）；술후30 d 초보납조LVEF、LVEDD 균우우초산감유조（t ＝2．330、4．908，P ＜0．05）。결론：경미도관향관상동맥병변원단주입초보납가유효처리재AMI 환자PCI 술중출현적무복류현상，안전역행。
Aim:To evaluate the clinical efficacy and safety of nitroprusside disposed no-reflow phenomenon for patients with acute myocardial infarction(AMI) during percutaneous coronary intervention(PCI).Methods:A total of 72 patients with AMI who had no-reflow phenomenon during PCI treatment were divided into nitroprusside group(n=36) and nitroglycerin group (n=36).Nitroprusside or nitroprusside was rapidly injected into the distal coronary artery lesions through micro catheter , and 10 min later, TIMI flow grade was assessed by coronary angiography.Blood pressure of intraoperative and 24 h after operation, ma-jor adverse cardiovascular events(MACE) incidence and the cardiac function(LVEF and LVEDD) in the first thirty days after PCI were compared between the two groups.Results:There was no significant difference in TIMI flow grade (P=0.262) and MACE incidence ( P>0.05) between the two groups; intraoperative and postoperative blood pressure were not significantly changed(P>0.05).LVEF and LVEDD were higher in nitroprusside group(t=2.330,4.908,P<0.05).Conclusion:Nitroprus-side could effectively dispose no-reflow phenomenon in patients with AMI during PCI, and is safe and easy.