急诊冠状动脉内支架术后无复流机制探讨与临床分析

Emergency coronary stenting no-reflow mechanisms and treatment strategies

目的:探讨冠心病患者进行急性冠状动脉内支架术后无复流发生机制。方法:选取150例患者,随机分成支架置入术组+安慰剂组与支架置入术+普萘洛尔两组,每组各75例。观察术后无复流现象的发生率及比较血管内皮功能的恢复情况。结果:支架置入术+普萘洛尔组发生无复流情况只有4%,而支架置入术组+安慰剂组发生率高达20%,并且反映血管内皮功能指标的内皮素-1(ET-1)的、血管性血友病友子(vWF)恢复情况也由术前的85.56±24.61pg/ml与118.7±52.44%恢复到术后的56.43±16.65pg/ml及96.3±34.6%,而一氧化氮(NO)则由术前的42.81±16.13μmol/L,恢复到68.11±18.94μmol/L。结论:使用普萘洛尔进行辅助冠状动脉内支架术治疗,能够降低术后无复流的现象。是一种新的治疗思路。

Objective：To determine the effect of coronary stenting on myocardium no-reflow after recanalization in patients with acute myocardial infarction.Methods：A total of 150 AMI patients undergoing percutaneous coronary intervention were randomly divided into stenting group（n=75） and stenting with Propranolol.Results： The no-reflow rate of stenting with Propranolol group（4%）was lower than that of stenting group（20%）;Reflect endothelial function index ET-1,vWF is also the recovery from preoperative 85.56 ± 24.61pg/ml and 118.7 ± 52.44% to postoperative recovery after the 56.43 ± 16.65pg/ml and 96.3 ± 34.6%,while NO from preoperative 42.81 ± 16.13μmol / L,back to 68.11 ± 18.94.Conclusion ： Using propranolol for treatment of secondary coronary stenting can reduce no-reflow phenomenon.