小剂量依替巴肽联合冠状动脉介入治疗对急性心肌梗死患者血流灌注及心功能的影响

Effects of low-dose etibaptide combined with PCI on blood flow perfusion and cardiac function in patients with acute myocardial infarction

目的探讨小剂量依替巴肽联合冠状动脉介入治疗(percutaneous coronary interventions,PCI)对急性心肌梗死(acute myocardial infarction,AMI)患者血流灌注及心功能的影响。方法2018年10月至2019年5月就诊并行急诊PCI的ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者。符合纳入标准及排除标准的行急诊PCI的STEMI患者随机分为试验组和对照组。试验组静脉内给予1次(180μg/kg)依替巴肽,后静脉泵入1μg/(kg·min);对照组不予注射及泵入。观察指标包括一般资料、心肌灌注及心功能指标及主要不良心脏事件(major adverse cardiac events,MACE)。结果试验组ST段回落率优于对照组(P<0.05)。试验组心肌声学造影中,峰值强度(peak intensity,PI)高于对照组,达峰时间(time to peak,TP)低于对照组(P<0.05)。术后1个月,试验组LVEF明显高于对照组,BNP水平明显低于对照组(P<0.05)。结论应用小剂量依替巴肽可以改善急性STEMI患者的心肌再灌注及心功能,且不增加MACE的发生率。

Objective To investigate the effect of low-dose etibatide combined with percutaneous coronary intervention(PCI)on blood perfusion and cardiac function in patients with acute myocardial infarction(AMI).Methods The patients with ST segment elevation myocardial infarction(STEMI)who underwent emergency PCI were selected.STEMI patients who met the inclusion and exclusion criteria were randomly divided into experimental group and control group.In experimental group,etibatide was given intravenously once(180μg/kg)and pumped intravenously 1μg/(kg·min);in control group,neither injection nor pump was given.The observation indexes included general data,myocardial perfusion,cardiac function and major adverse cardiac events(MACE).Results The rate of ST fall in experimental group was better than that in control group(P<0.05).The peak intensity(PI)in experimental group were significantly higher than that in control group,however,the time to peak(TP)of myocardial contrast echocardiography was lower than that in control group(P<0.05).LVEF in experimental group was significantly higher than that in control group in the first month after the operation,and BNP level in experimental group was significantly lower than that in control group in the first month(P<0.05).Conclusion Low dose of etibatide can improve myocardial reperfusion and cardiac function in patients with acute STEMI without increasing the incidence of MACE.