胺碘酮对AMI患者PCI术后发生再灌注心律失常的保护作用

Amiodarone against reperfusion arrhythmia after percutaneous coronary intervention in patients with acute myocardial infarction

目的观察胺碘酮对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后再灌注心律失常(RA)的影响,并探讨其可能机制。方法前瞻性选择2017年6月至2018年2月至首都医科大学附属北京地坛医院就诊的AMI患者264例,随机分为常规PCI组和胺碘酮干预组,各132例。常规PCI组采用PCI和其他常规治疗,胺碘酮干预组在此基础上加用胺碘酮。观察术后RA的发生情况,并比较两组患者治疗前后血清白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、心肌肌钙蛋白I(cTnI)和肌酸激酶同功酶(CK-MB)水平的变化。结果胺碘酮干预组RA的发生率明显低于常规PCI组,差异有统计学意义(P <0. 01)。且胺碘酮干预组患者术后IL-6、hs-CRP、cTnI和CK-MB水平明显低于常规PCI组,差异均有统计学意义(P <0. 05)。结论胺碘酮对预防AMI患者PCI术后发生RA有较好的临床疗效,其能降低患者血清IL-6、hs-CRP、CK-MB和cTnI水平,减轻再灌注带来的损伤,从而减少RA的发生。

Objective To observe the effect of amiodarone on reperfusion arrhythmia(RA)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)and to explore possible mechanism.Methods 264 patients with AMI from August 2017 to February 2018 in our hospital were randomized into conventional PCI group(n=132)and amiodarone intervention group(n=132).The occurrence of post-PCI RA and serum levels of IL-6,hs-CRP,cTnI and CK-MB were compared for the two groups before and after treatment.Results The incidence of RA in the amiodarone intervention group was significantly lower than that in the conventional PCI group(P<0.01).The IL-6,hs-CRP,cTnI and CK-MB levels in the amiodarone intervention group were significantly lower than those in the conventional PCI group(P<0.05).Conclusion Amiodarone protects against post-PCI RA in AMI patients through reduction of IL-6,hs-CRP,cTnI and CK-MB thus alleviation of the damage caused by reperfusion.