冠脉内注射肾上腺素和维拉帕米对心肌梗死患者PCI术中慢血流的影响

Comparison of Intra-coronary Injection of Different Drugs on Slow Blood Flow in Patients with Myocardial Infarction

【目的】比较冠脉内注射肾上腺素和维拉帕米对急性心肌梗死（AMI）患者经皮冠状动脉介入术（PCI）中慢血流的影响。【方法】回顾性分析2016年6月至2017年6月本院收治的行PCI治疗的98例AMI患者的临床资料，所有患者均行PCI术治疗。根据冠脉内注射药物的不同将其分为A组（冠脉内注射肾上腺素，n=49）和B组（冠脉内注射维拉帕米，n=49）。比较两组患者的冠脉血流情况、血清炎性因子水平和心血管不良事件发生情况。【结果】两组患者病变血管支数情况比较，差异无统计学意义（P〉0．05）。术后A组患者恢复Ⅲ级TIMI血流率显著高于B组，达到Ⅲ级TIMI血流时间低于B组，差异具有统计学意义（P〈0．05）。A组PCI术后血清超敏C反应蛋白（hs—CRP）、肌酸激酶同工酶（CK—MB）水平显著低于B组，差异具有统计学意义（P〈0．05）；两组血清氨基末端B型脑钠肽前体（NT-proBNP）、肌钙蛋白T（cTnT）水平比较，差异无统计学意义（P〉0．05）。A组心血管不良事件发生率为6．12％（3／49）显著低于B组的12．24％（6／49），差异具有统计学意义（x^2=7．354，P=0．017〈0．05）。【结论】心肌梗死PCI术患者术中冠脉注射肾上腺素和维拉帕米均能改善术中慢血流情况，而注射肾上腺素改善效果较佳，安全性较好。

[Objective]To compare the effects of intracoronary injection of adrenalin or verapamil on slow blood flow during percutaneous coronary intervention （PCI） in patients with acute myocardial infarction （AMI）.[Methods]The clini cal data of 98 AMI patients treated with PCI from June 2016 to June 2017 were analyzed retrospectively. All patients were treated with PCL The patients were divided into two groups： group A （intracoronary injection of epinephrine） and group B （intracoronary injection of verapamil）. The coronary blood flow, serum inflammatory factor level and cardiovascular ad verse events were compared between the two groups.[Results]There was no significant difference in the number of vessel branches between the two groups （ P 〉0.05）. The recovery rate of grade Ⅲ TIMI in the group A was significantly higher than that in the group B, and the blood flow time to grade Ⅲ TIMI was lower in the group A than in the group B. The difference was statistically significant （ P 〈0.05）. The levels of serum hypersensitive C-reactive protein （hs-CRP） and creatine kinase isoenzyme （CK-MB） were significantly lower in the group A than the in the group B after PCI. There was no significant difference in the levels of NT-proBNP and cTnT between the two groups（ P 〉0.05）. The incidence of cardiovascular adverse events in the group A 6.12 % （3/49） was significantly lower than that the in the group B 12.24 % （6/ 49）, and the difference was statistically significant （x^2= 7.354, P =0.017〈0.05）.[Conclusion]Both adrenalin and verapamil can improve the slow blood flow in patients with myocardial infarction （PCI）, while adrenalin injection has better effect and safety.