腺苷治疗经皮冠状动脉介入术中无复流现象的临床研究

Clinical research for adenosine treatment of patients with no-reflow phenomenon in percutaneous coronary intervention

目的观察腺苷对急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术中无复流的治疗效果。方法PCI术中无复流的患者52例,随机分为腺苷治疗组(n=26)和对照组(n=26),观察用药后靶血管前向血流的TIMI分级情况、心电图变化情况、心动过缓及房室传导阻滞的发生情况和主要终点事件的发生情况。结果腺苷组术后靶血管TIMI血流明显高于对照组(P<0.05),差异有统计学意义,术后90 min心电图明显改善,l周内主要终点事件中死亡、缺血性胸痛、再次心肌梗死发生率明显低于对照组(P<0.05),术中并发严重心动过缓及房室传导阻滞的发生率两组无明显差异。结论腺苷可以有效改善PCI术中无复流现象并减少术后1周内主要终点事件发生。

Objective To observe the effects of adenosine on acute coronary syndrome（ACS） patients of no-reflow undergoing percutaneous coronary intervention（PCI）.Methods 52 ACS patients with no-reflow in PCI were randomly divided into adenosine treatment group（n=26） and control group（n=26）,were observed after the target vessel forward blood flow in TIMI grading,electrocardiographic changes,slow heartbeat and atrioventricular conduction block occurred and the occurrence of the primary endpoint events.Results Adenosine groups after the target vessel TIMI blood flow was significantly higher than that of control group（P0.05）,after 90 min,the ECG of adenosine treatment groups were improved apparently,l weeks primary endpoint of death,ischemic chest pain,myocardial infarction incidence is significantly lower than that of control group（P0.05）,operation complicated with severe heartbeat bradycardia and complete atrioventricular block occurring rate had no difference between the two groups.Conclusion Adenosine can effectively improve the PCI intraoperative no-reflow phenomenon and reduce the postoperative 1 weeks the primary endpoint events occur.