经冠状动脉微导管注射硝普钠在急性ST段抬高型心肌梗死中的应用效果

Effect of Sodium Nitroprusside Injection Through Coronary Microcatheter in Acute STEMI

目的探讨经冠状动脉微导管注射硝普钠在急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)中的应用效果。方法在大厂回族自治县人民医院接受经皮冠状动脉介入治疗(PCI)的急性STEMI患者若干例,基于特定时间段内(2018年10月-2019年10月)对其进行选取(100例),将上述患者信息均输入Excel系统进行编号,按照编号的单双数分为2组(各50例),其中50例单数者设为对照组,在支架置入后PCI微导管中注射硝酸甘油治疗,50例双数者设为观察组,在支架置入后PCI微导管中注射硝普钠治疗,以SPSS 23.0作为统计学软件,对比分析两组患者心功能、无复流现象恢复情况、心肌损伤标志物、心脏不良事件发生情况。结果治疗后,观察组心肌梗死溶栓(TIMI)血流分级、心功能改善情况显著优于对照组(P<0.05);术后24h观察组BNP、CK-MB水平与对照组相比差异显著(P<0.05);观察组心脏不良事件发生率为4.00%,与对照组的10.00%对比无显著差异(P>0.05)。结论采用经冠状动脉微导管注射硝普钠治疗急性STEMI,可明显改善患者症状,减轻心肌受损,调整心功能恢复正常状态,降低不良事件的发生。

Objective To investigate the effect of sodium nitroprusside injection through coronary microcatheter in acute ST segment elevation myocardial infarction(STEMI).Methods Several patients with acute STEMI who received percutaneous coronary intervention(PCI)in our hospital were selected(100 cases)based on a specific time period(October 2018 October 2019).The above patient information was input into excel system for numbering.They were divided into two groups(50 cases in each group)according to the odd and even numbers,of which 50 cases were set as the control group,Nitroglycerin was injected into the PCI microcatheter after stent implantation.50 patients with an even number were set as the observation group.Sodium nitroprusside was injected into the PCI microcatheter after stent implantation.Spss23.0 was used as the statistical software to compare and analyze the cardiac function,recovery without reflow,cardiac muscle injury markers and adverse cardiac events between the two groups.Results After treatment,the improvement of TIMI blood flow grade and cardiac function in the observation group were significantly better than those in the control group(P<0.05);The levels of BNP and CK-MB in the observation group were significantly higher than those in the control group 24 hours after operation(P<0.05);The incidence of adverse cardiac events in the observation group was 4.00%,which had no significant difference compared with 10.00%in the control group(P>0.05).Conclusion Injection of sodium nitroprusside through coronary microcatheter in the treatment of acute STEMI can significantly improve patients’symptoms,reduce myocardial damage,adjust cardiac function,restore normal state and reduce the incidence of adverse events.