双嘧达莫丹参酮ⅡA磺酸钠联合应用治疗冠状动脉慢血流现象有效性与安全性对比研究

Efficacy and Safety of Dipyridamole and Sodium Tanshinone ⅡA on Treatment of Coronary Slow Flow Phenomenon

目的对比研究应用双嘧达莫、丹参酮ⅡA磺酸钠(STS)和联合双嘧达莫、STS治疗冠状动脉慢血流现象的有效性及安全性。方法将80例冠脉造影术时发现冠状动脉慢血流现象的患者随机分为三组,成功置入鞘管后,分别于造影导管内注入双嘧达莫400μg、STS 400μg、双嘧达莫200μg加STS 400μg,分别测定注入药物前后病变血管的TIMI血流和校正的TIMI帧数,同时心电血压监护仪记录注入药物前后患者最低血压、心率及观察局部和全身症状的发生情况。结果(1)联合药物组和双嘧达莫组对血流速度的改善明显优于STS组,而联合药物组又优于双嘧达莫组,组间差异均有统计学意义。(2)3组局部症状发生率及对血压、心率和心电影响的组间比较均无统计学意义,但联合药物组全身症状发生率低于双嘧达莫组。结论冠脉造影术时联合应用双嘧达莫和STS冠脉内注射可有效治疗慢血流,并且对心率、血压和心电的影响较小,全身及局部症状发生率低,患者耐受性好,且并发症少,比单一应用双嘧达莫或STS具有优越性,易为患者接受。

Objective To investigate the efficacy and safety of Dipyridamole and Sodium Tanshinone ⅡA when injected into the coronary in order to improve coronary slow flow phenomenon during the coronary angiography. Methods 80 patients who had been arranged to angiography and were confirmed coronary slow flow Phenomenon in our hospital were randomly divided into 3 groups. Dipyridamole 400μg, Sodium Tanshinone ⅡA 400μg and Dipyridamole 200μg plus Sodium Tanshinone ⅡA 400μg were injected into coronary after sheath tube was planted successfully. Coronary flow rates of all patients were documented by Thrombolysis In Myocardial Infarction frame count（ TIMI frame count）. The heart rate, the blood pressure,and electrocardiogram were recorded. Furthermore, general condition were observed. Results （ 1 ） The improvement of flow velocity of Dipyridamole plus Sodium Tanshinone ⅡA group and Dipyridamole group are superior to Sodium Tanshinone ⅡA group. （2） The incidence of local symptoms and blood pressure, heart rate, electrocardiogram did not show statistical notability among the 3 groups. However, the incidence of systemic symptoms in the combination group is lower than Dipyridamole group. Conclusion During the coronary angiography, Dipyridamole 200μg plus Sodium Tanshinone ⅡA 400μg injected into coronary can improve coronary slow flow phenomenon effectively and has no effect on patient＇s heart rate, blood pressure and electrocardiogram,and it has been accepted more easily by patients than Dipyridamole or Sodium Tanshinone ⅡA because of the less complication and good general condition.