围术期应用磷酸肌酸对经皮冠状动脉介入治疗心肌的保护作用△

目的评价经皮冠状动脉介入治疗围术期应用磷酸肌酸的心肌保护作用。方法2009年2月至2010年11月在汕头市第二人民医院住院确诊为心绞痛的患者80例，按电脑随机数字法分为治疗组（n=40）和对照组（n=40）。治疗组在常规治疗的基础上，经皮冠状动脉介入治疗前后采用磷酸肌酸注射液静脉注射。观察充气过程中心电图ST—T的改变，心绞痛发生情况与充气的关系。术前及术后行心脏肌钙蛋白I及血清C反应蛋白浓度测定。结果治疗组sT段抬高的程度低于对照组（1．27±0．49）mmvs．（2．19±0．66）mm，P=0．036]，术中耐受心肌缺血程度治疗组优于对照组，发生心律失常的情况10．0％（4／40）vs．27．5％（11／40），X^2=4．021，P=0．045]治疗组低于对照组，差异均有统计学意义。治疗组患者术后心脏肌钙蛋白I峰值（0．30±0．12）ng／mLvs（0．42±0．29）ng／mL，P〈0．05]及血清C反应蛋白浓度（16．00±2．77）mg／Lvs（19．15±4．39）mg／L，P〈0．05]均低于对照组．差异有统计学意义。结论经皮冠状动脉介入治疗围术期应用磷酸肌酸有助于术中减少心绞痛的发生，提高心肌缺血的耐受程度．减少心律失常的发生并抑制体内的炎症反应。

Myocardial protective effect of creatine phosphate during perioperative percutaneous coronary intervention

Objectives To evaluate the eitect oi creatme phosphate m myocardial protection dunng penoperative percutaneous coronary intervention（PCI）. Methods Eighty patients diagnosed as angina pectoris were randomly divided into treatment group （n=40） and control group （n=40）. Excepting for general treatment, creatine phosphate through intravenous infusion before and after PCI was used in treatment group. ST-T changes during inflatable process, relation between angina and inflatable were observed. Cardiac troponin I （cTnI） and C-reactive protein （CRP） were measured before and after PCI. Results ST segment elevation in treatment group was significantly lower than that in control group （1.27±0.49） mm vs. （2.19±0.66） ram, P=0.036 ]. Tolerance to myocardial ischemia degree in treatment group was better than that in control group during PCI （P〈0.05）. Incidence of arrhythmia in treatment group was markly lower than that in control group 10.0% （4/40） vs. 27.5% （ll/40）,X^2=4.021,P=0.045].Peak of cTnI and serum consentration of CRP in treatment group were significantly lower than those in control group （0.30±0.12）ng/mL vs. （0.42±0.29） ng/mL,P〈O.05; （16.00±2.77）mg/L vs.（19.15±4.39）mg/L,P〈0.05]. Conclusions Creatine phosphate used in perioperative PCI can reduce angina incidence, increase tolerance of myocardial ischemia, reduce arrhythmia incidence and inhibit the inflammatory response in patients during perioperative PCI.