加压快速静脉滴注参附对急性下壁心肌梗死患者血流动力学的影响

Effects of pressurized rapid intravenous infusion of Shenfu on hemodynamics in patients with acute inferior myocardial infarction

目的观察加压快速静脉滴注参附注射液对急性下壁心肌梗死患者血流动力学的影响。方法选取急性下壁心肌梗死患者120例,按照数字随机表法分为观察组和对照组各60例,对照组在经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)时静脉输注生理盐水,观察组在对照组的基础上加压快速静脉滴注参附注射液。比较2组血流动力学指标以及入院门至导丝通过时间(D-to-B时间)、术后血流分级、不良反应和30d内主要不良心血管事件。结果术前2组患者的心率(heart rate,HR)、左心室舒张末期压(left ventricular diastolic pressure,LVEDP)、心率与收缩压的乘积(real portfolio project,RPP)、室内压最大升降速率(maximal rising and falling rate of ventricular pressure,±dp/dtmax)差异均无统计学意义(P>0.05)。术后2组用药后40min的HR、±dP/dtmax升高而LVEDP、RPP降低(P<0.05),术后观察组HR和RPP均显著低于对对照组(P<0.05)。观察组PCI术D-to-B时间显著短于对照组(P<0.05)。2组TIMI血流分级比率差异无统计学意义(P>0.05)。观察组不良反应发生率及术后30d内MACE出现率显著低于对照组(P<0.05)。结论在PCI术中加压快速静脉滴注参附注射液可有效改善患者血流,并平稳增加心率以及血压,降低恶心呕吐心律失常发生率以及主要不良心血管事件,具有安全性,值得推广。

Objective To investigate the effect of rapid intravenous infusion of Shenfu on hemodynamics in patients with acute inferior myocardial infarction.Methods One hundred and twenty patients with acute inferior wall myocardial infarction who underwent percutaneous coronary intervention were randomly divided into observation group and control group,60 cases in each group.The control group was treated with percutaneous coronary intervention（PCI）Infusion of normal saline,the observation group received treatment of rapid intravenous infusion of Shenfu injection on the basis of the control group.The hemodynamic parameters,D-to-B time,postoperative blood flow classification,adverse reactions,and 30 days of major adverse cardiovascular events were compared between the two groups before and after surgery.ResultsThere was no significant difference in heart rate（HR）,left ventricular diastolic pressure（LVEDP）,real portfolio project（RPP）,maximal rising and falling rate of ventricular pressure（±dP/dtmax）between two groups before operation（P〉0.05）.Both HR and±dP/dtmax at 40 minutes were increased,and LVEDP and RPP were decreased after surgery（P〈0.05）.The HR and RPP of the observation group were significantly lower than those of the control group（P〈0.05）.The duration of D-to-B in the observation group was significantly shorter than that in the control group（P〈0.05）.There was no significant difference in TIMI blood flow grade between two groups（P〉0.05）.The incidence of adverse events in the observation group and the incidence of MACE in the 30 days after operation were significantly lower than those in the control group（P〈0.05）.Conclusion In the PCI,rapid intravenous infusion of Shenfu injection can effectively improve the patient′s blood flow,and steadily increase the heart rate and blood pressure,reduce the incidence of nausea and vomiting arrhythmia and the main adverse cardiovascular events,with safety,which is worthy of promotion.