前列地尔对急性冠脉综合征PCI术后心肌灌注及心功能的影响

Effect of alprostadil on myocardial perfusion and cardiac function in patients with acute coronary syndrome after percutaneous coronary intervention

目的探讨前列地尔对急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)术后心肌灌注及心功能的影响。方法选择渭南市第二医院心内科于2014年1月至2017年1月期间收治的198例ACS患者为研究对象,根据随机数表法分为观察组和对照组,每组99例,观察组在PCI围手术期应用前列地尔,对照组则不予应用前列地尔,比较两组患者术前及术后心肌梗塞溶栓治疗(TIMI)血流及心肌灌注分级情况,以及左心室射血分数(LVEF)、血清脑钠肽(BNP)水平的变化。结果 PCI术后,观察组患者的TIMI血流分级Ⅱ~Ⅲ级及心肌灌注分级Ⅱ~Ⅲ级的比例分别为92.93%和94.95%,明显高于对照组的83.84%和81.82%,差异均有统计学意义(P<0.05);观察组患者LVEF为(53.6±7.2)%,明显高于对照组的(48.3±5.4)%,血清BNP水平为(142.7±50.8)pg/mL,明显低于对照组的(185.4±72.4)pg/mL,差异均有统计学意义(P<0.05)。结论急性冠脉综合征患者择期PCI术围手术期应用前列地尔可以明显提高PCI术后的心肌灌注,改善患者的心功能。

Objective To investigate the effect of alprostadil on myocardial perfusion and cardiac function in patients with acute coronary syndrome （ACS） after percutaneous coronary intervention （PCI）. Methods A total of 198 patients with ACS, who admitted to Department of Cardiology in Weinan Second Hospital during January 2014 to January 2017, were selected and divided into the observation group and the control group according to random number table method, with 99 cases in each group. The observation group was treated with alprostadil in the perioperative period of PCI, while the control group was treated without alprostadil. Thrombolysis in myocardial infarction （TIMI） flow and the myo- cardial perfusion, left ventricular ejection fraction （LVEF）, and serum brain natriuretic peptide （BNP） level change before and after the therapy in the two groups were compared. Results After PCI, the TIMI blood flow grade Ⅱ - Ⅲ and myo- cardial perfusion grade Ⅱ - Ⅲ rate were 92.93% and 94.95% in observation group, which were significantly higher than 83.84% and 81.82% in the control group （P〈0.05）; the LVEF and serum BNP were （53.6±7.2）% and （142.7±50.8） pg/mL in the observation group versus （48.3±5.4）% and （185.4±72.4） pg/mL in the control group （P〈0.05）. Conclusion A1- prostadil can improve the myocardial perfusion after PCI and the cardiac function in patients with ACS undergoing elective PCI.