摘要
目的 观察右美托咪定联合舒芬太尼对急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)治疗术后的临床应用价值。方法 回顾性研究AMI患者,按照治疗方案不同分为对照组和试验组。2组均进行PCI术,对照组给予舒芬太尼,试验组给予右美托咪定联合舒芬太尼。比较2组不同时刻心率(HR)、平均动脉压(MAP),比较术后不同时刻视觉模拟评分(VAS)、Ramsay评分,及术前、术后48 h心肌酶谱指标[肌酸激酶同工酶(CK-MB)、肌红蛋白(MYO)、N末端脑钠肽前体(NT-proBNP)、肌钙蛋白Ⅰ(cTnⅠ)],并记录2组药物不良反应发生情况。结果 本研究共纳入109例AMI患者,对照组最终纳入54例,试验组最终纳入55例。对照组、试验组手术开始25 min HR分别为(112.32±10.32)和(97.52±11.32)次/分,MAP为(105.69±8.72)和(101.69±6.87)mmHg,差异均有统计学意义(均P<0.05)。对照组术后6、12、24和48 h的VAS分别为(4.58±1.12)、(4.10±0.78)、(2.32±0.85)和(2.12±0.59)分,试验组分别为(4.12±0.32)、(3.85±0.92)、(2.02±0.68)和(1.89±0.42)分,差异均有统计学意义(均P<0.05)。对照组、试验组术后48 h CK-MB分别为(149.42±20.78)和(110.49±17.13)ng·mL^(-1),NT-proBNP分别为(1.09±0.42)和(0.92±0.15)ng·L^(-1),MYO分别为(78.51±7.85)和(59.42±7.10)pg·mL^(-1),cTnⅠ分别为(16.78±3.12)和(11.24±2.57)pg·mL^(-1),差异均有统计学意义均(均P<0.05)。试验组和对照组的药物不良反应发生率分别为9.09%和5.56%,差异无统计学意义(P>0.05)。结论 右美托咪定联合舒芬太尼用于治疗AMI患者PCI术可改善血流动力学指标,并减轻术后疼痛、心肌酶谱,安全性较好。
Objective To observe the clinical value of dexmedetomidine combined with sufentanil in patients with acute myocardial infarction(AMI) after percutaneous coronary artery therapy(PCI).Methods A retrospective study was conducted on patients with AMI,and were divided into control group and treatment group according to different treatment plans.Both groups were given PCI.The control group was given sufentanil,and the treatment group was given dexmedetomidine combined sufentanil.Heart rate(HR),mean arterial pressure(MAP),visual analogue scale(VAS) and Ramsay score were compared between the two groups at different times,myocardial enzyme profile indexes(creatine kinase isoenzyme(CK-MB),N-terminal brain natriuretic peptide precursor(NT-proBNP),myoglobin(MYO),troponinⅠ(cTn Ⅰ) were recorded before and 48 h after surgery,and the occurrence of adverse drug reactions in the two groups were recorded.Results A total of 109 patients with AMI were included in this study,including 54 patients in control group and 55 patients in treatment group.In the control group and the treatment group,the initial 25 min HR were(112.32±10.32) and(97.52±11.32) beat·min^(-1),the MAP were(105.69±8.72) and(101.69±6.87)mmHg,there were significant differences between the two groups(all P <0.05).The VAS scores at 6,12,24 and 48h of control group were 4.58±1.12,4.10±0.78,2.32±0.85 and 2.12±0.59,which in treatment group were4.12±0.32,3.85±0.92,2.02±0.68 and 1.89±0.42,the differences between the two groups were all statistically significant(all P<0.05).At 48 h after operation,the CK-MB in control group and the treatment group were(149.42±20.78) and(110.49±17.13) ng·mL^(-1),the NT-proBNP were(1.09±0.42) and(0.92±0.15)ng·L^(-1),MYO were(78.51±7.85) and(59.42±7.10) pg·mL^(-1),cTn I were(16.78±3.12) and(11.24±2.57) pg·mL^(-1),there were statistically significant differences between the two groups(all P <0.05).There was no significant difference in the incidence of adverse drug reactions between treatment group(9.09%) and the control group(5.56%,P>0.05).Conclusion Dexmedetomidine combined with sufentanil in the treatment of AMI patients after PCI can improve hemodynamic indexes,and reduce postoperative pain,myocardial enzyme spectrum,and have good safety.
作者
崔少华
耿晓玲
杨晓玮
CUI Shao-hua;GENG Xiao-ling;YANG Xiao-wei(Department of Critical Care Medicine,The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014010,Inner Mongolia,China;Department of Anesthesiology,the Fourth Hospital of Baotou,Baotou 014030,Inner Mongolia,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2023年第24期3556-3560,共5页
The Chinese Journal of Clinical Pharmacology
关键词
右美托咪定
舒芬太尼
急性心肌梗死
经皮冠状动脉介入
疼痛
心肌酶谱
dexmedetomidine
sufentanil
acute myocardial infarction
percutaneous coronary intervention
pain
myocardial zymogram