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Received:November 19, 2021 Published Online:May 20, 2022
Received:November 19, 2021 Published Online:May 20, 2022
中文摘要: 目的 探讨依替巴肽三种给药途径在高血栓负荷急性ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入术(PCI)中的临床效果。方法 选取2018年5月至2021年7月在湛江中心人民医院诊治的300例高血栓负荷的急性STEMI患者作为研究对象。随机分为A、B、C组,每组100例。3组均行PCI,A组静脉推注依替巴肽,B组在冠状动脉内注入依替巴肽,C组在病变部位注入依替巴肽。对比3组的梗死心外膜大血管血流灌注水平、PCI术后心肌微循环指标、心肌损伤面积指标、住院期间出血情况和3个月随访结果。结果 与A组相比,B组和C组的心肌呈色分级、左心室射血分数(LVEF)均升高,校正TIMI帧幅数(cTFC)、磷酸肌酸激同工酶(CK-MB)、CK-MB峰值、肌钙蛋白I(cTnⅠ)、cTnⅠ峰值、N-末端B型利钠肽前体(NT-proBNP)水平和心脏不良事件(MACE)总发生率均降低,ST段回落程度均明显大(P<0.05)。与B组相比,C组的心肌呈色分级、LVEF均升高,cTFC、CK-MB、CK-MB峰值、cTnⅠ、cTnⅠ峰值、NT-proBNP水平和MACE总发生率均降低,ST段回落程度明显大(P<0.05)。结论 在高血栓负荷急性STEMI PCI中,病变部位注入依替巴肽在改善心肌微循环灌注、减轻心肌损伤面积、PCI术后心功能及降低MACE方面的效果最好,冠状动脉内注入依替巴肽次之。
中文关键词: 高血栓负荷 心肌梗死,急性ST段抬高型 经皮冠状动脉介入术 依替巴肽 用药途径
Abstract:ObjectiveTo investigate the clinical effects of three route of etibatide administration in percutaneous coronary intervention (PCI) of acute ST-segment elevation myocardial infarction (STEMI) with high thrombotic load. Methods A total of 300 patients with acute STEMI with high thrombus burden treated in Central People's Hospital of Zhanjiang from May 2018 to July 2021 were selected and randomized to grouPA, B and C, with 100 cases in each group. PCI was performed in all three groups, etibatide was injected intravenously in grouPA, etibatide was injected into the coronary artery in grouPB, and etibatide was injected into the lesion site in grouPC. The blood perfusion level of epicardial vessels, myocardial microcirculation index, myocardial injury area index, bleeding during hospitalization and 3-month follow-uPresults were compared among three groups. Results Compared with grouPA, the myocardial color grading, left ventricular ejection fraction (LVEF) in grouPB and grouPC were significantly higher, corrected TIMI frame number(cTFC), creatine kinase isoenzyme(CK-MB),CK-MB peak, troponin I(cTn I), cTn I peak, N-terminal B-type natriuretic peptide precursor(NT-proBNP) level and the total incidence of adverse cardiac events(MACE) in grouPB and grouPC were significantly lower, the degree of ST segment decline in grouPB and grouPC were significantly greater (P<0.05). Compared with grouPB, the myocardial color grading, LVEF in grouPC were significantly higher, cTFC, CK-MB, CK-MB peak, cTn I, cTn I peak, NT-proBNPlevel and the total incidence of MACE in grouPC were significantly lower, the degree of ST segment decline in grouPC were significantly greater(P<0.05). Conclusions In PCI of acute STEMI with high thrombotic load, injection of etibatide into the lesion site has the best effect in improving myocardial microcirculation perfusion, reducing myocardial injury area, cardiac function after PCI, and reducing MACE after PCI, followed by intracoronary injection of etibatide.
keywords: High thrombus load Myocardial infarction, acute ST segment elevation Percutaneous coronary intervention Etibatide Medication route
文章编号: 中图分类号: 文献标志码:A
基金项目:广东省医学科学技术研究基金(B2020226)
Author Name | Affiliation |
CHEN Jie, ZHANG Bin, CHEN Dan, ZHOU Zhi-chao | Department of Cardiology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong 524045, China |
Author Name | Affiliation |
CHEN Jie, ZHANG Bin, CHEN Dan, ZHOU Zhi-chao | Department of Cardiology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong 524045, China |
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