依替巴肽联合前列地尔对急性ST段抬高型心肌梗死患者pPCI术后心肌微循环的影响

doi:10.3969/j.issn.1007-3205.2020.04.003

河北医科大学学报

依替巴肽联合前列地尔对急性ST段抬高型心肌梗死患者pPCI术后心肌微循环的影响

1.河北省邯郸市中心医院心内五科，河北邯郸 056002；2.冀中能源峰峰矿区总医院普外二科，河北峰峰 056200；
3.河北医科大学第二医院心内五科，河北石家庄 050000

出版日期:2020-04-25 发布日期:2020-05-15
作者简介:王海燕（1982-），女，河北邯郸人，河北省邯郸市中心医院主治医院，医学博士研究生，从事心血管内科疾病诊治研究。

Effect of Eptifibatide combined with Prostaglandin E1 on myocardial microcirculation after pPCI in STEMI patients

1.The Fifth Department of Cardiology, Handan Central Hospital, Hebei Province, Handan 056002, China;
2.The Second Department of General Surgery, Jizhong Energy Fengfeng Group General Hospital, Hebei
Province, Fengfeng 056200, China; 3.The Fifth Department of Cardiology, the Second Hospital of
Hebei Medical University, Hebei Province, Shijiazhuang 050000, China

Online:2020-04-25 Published:2020-05-15

摘要/Abstract

摘要： ［摘要］
目的探讨依替巴肽联合前列地尔对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction, STEMI)患者直接经皮冠状动脉介入术(primary percutaneous coronary intervention,pPCI)后心肌微循环的影响。
方法选择急性STEMI患者162例, 随机分为对照组和观察组各81例。所有患者均于术前30 min静脉给予前列地尔，术后维持7 d；而观察组术中冠状动脉内给予依替巴肽，术后静脉持续18 h。观察pPCI术前及术后梗死相关动脉(infarction related artery, IRA)的心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI) 血流分级、校正TIMI帧幅数(corrected TIMI frame count,cTFC)、术后90 min心电图ST段回落(ST-segment resolution,STR)程度、肌酸激酶同工酶(creatine kinase isoenzyme-MB,CK-MB) 和肌钙蛋白I(cardiac troponin-I,cTnI)术前值及术后峰值，入院时和术后1周左心室射血分数(left ventricular ejection fraction,LVEF)和室壁运动积分指数(wall motion score index,WMSI)，术后48 h及术后1周心肌声学造影。
结果 2组患者在基本资料、造影及介入资料上差异无统计学意义（P＞0.05）。观察组pPCI术后cTFC帧数、CK-MB和cTNI峰值较对照组明显降低（P＜0.05）；而术后TIMI 3级血流、90 min心电图STR程度、术后48 h和1周局部心肌血流量及1周后LVEF较对照组显著升高（P＜0.05）。
结论依替巴肽联合静脉注射前列地尔可有效地改善急性STEMI心肌灌注，改善心功能。

关键词: 心肌梗死, 血管成形术, 气囊, 冠状动脉, 前列地尔

Abstract: ［Abstract］ Objective〖HTSS〗To investigate the effect of Eptifibatide combined with Prostaglandin E1 on myocardial microcirculation in patients with acute ST-segment elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention(pPCI).
〖WTHZ〗Methods〖HTSS〗A total of 162 patients with acute STEMI were randomly divided into the control group(n=81) and the observation group(n=81). All patients were given Prostaglandin E1 intravenously 30 minutes before surgery and maintained for 7 days. In the observation group, the intracoronary artery was treated with Eptifibatide, and the postoperative venous duration was 18 hours. Thrombolysis in myocardial infarction(TIMI), corrected TIMI frame count(cTFC), ST-segment resolution(STR) rate of ECG, creatine kinase-MB(CK-MB), cardiac troponin I(cTnI), left ventricular ejection fraction(LVEF), and wall motion score index(WMSI) were measured before and after pPCI. Myocardial contrast echocardiography was performed 48 hours and 1 week after surgery, respectively.
〖WTHZ〗Results〖HTSS〗There was no statistical difference in basic clinical data, coronary angiography data and interventional data between two groups(P＞0.05). The cTFC frames, CK-MB and cTnI peaks in the observation group after pPCI were significantly lower than those in the control group(P＜0.05). However, the postoperative TIMI grade 3 blood flow, the decrease of electrocardiogram STR after 90min, the local myocardial blood flow 48 hours after the operation and 1 week after the operation, and the cardiac color doppler ultrasound LVEF were significantly increased compared with the control group(P＜0.05).
〖WTHZ〗Conclusion〖HTSS〗Eptifibatide combined with Prostaglandin E1 can effectively improve the myocardial perfusion of acute STEMI and myocardial function.

Key words: myocardial infarction, angioplasty, balloon, coronary, alprostadil

王海燕1，姜卫星2，田丽1，傅向华3. 依替巴肽联合前列地尔对急性ST段抬高型心肌梗死患者pPCI术后心肌微循环的影响[J]. 河北医科大学学报, doi: 10.3969/j.issn.1007-3205.2020.04.003.

WANG Hai-yan1, JIANG Wei-xing2, TIAN Li1, FU Xiang-hua3. Effect of Eptifibatide combined with Prostaglandin E1 on myocardial microcirculation after pPCI in STEMI patients[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.1007-3205.2020.04.003.

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依替巴肽联合前列地尔对急性ST段抬高型心肌梗死患者pPCI术后心肌微循环的影响

Effect of Eptifibatide combined with Prostaglandin E1 on myocardial microcirculation after pPCI in STEMI patients

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