冠状动脉内注射腺苷对急性心肌梗死再灌注后无复流的影响 |
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引用本文: | 李丹,王祖锦,王岚峰,杨树森,周立君,修春红,潘薇,李竹琴. 冠状动脉内注射腺苷对急性心肌梗死再灌注后无复流的影响[J]. 心脏杂志, 2009, 21(3): 371-374 |
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作者姓名: | 李丹 王祖锦 王岚峰 杨树森 周立君 修春红 潘薇 李竹琴 |
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作者单位: | 哈尔滨医科大学附属第一医院心内科,黑龙江 哈尔滨 150001 |
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基金项目: | 黑龙江省攻关课题项目资助 |
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摘 要: | 目的 评价冠状动脉内注射腺苷对急性心肌梗死(AMI)再灌注治疗后无复流的影响。方法 共62例行经皮冠状动脉介入治疗(PCI)的AMI患者,被随机分为对照组和腺苷组。以PCI后最终冠脉造影校正的心肌梗死溶栓试验血流帧数(corrected thrombolysis in myocardial infarction frame count,cTFC)为标准,当cTFC≥23时诊断为无复流。PCI前、后采集肘静脉血检测肌酸激酶同工酶(CK-MB)和超敏C反应蛋白(hsCRP)。比较两组无复流发生率及血浆心肌酶和炎症因子的变化。结果 腺苷组中无复流的发生率较对照组明显降低(P<0.05)。腺苷组CK-MB和hsCRP较对照组明显降低(P<0.05)。多元线性回归分析显示CK-MB、hsCRP与无复流显著相关(P<0.05)。结论 AMI患者冠脉内应用腺苷能有效降低无复流的发生,降低血浆心肌酶、炎症因子水平。
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关 键 词: | 腺苷 心肌梗死,急性 无复流 |
Effect of intracoronary injections of adenosine on no-reflow after reperfusion in acute myocardial infarction |
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Abstract: | AIM To evaluate the effect of intracoronary injections of adenosine on no-reflow after reperfusion in patients with acute myocardial infarction. METHORDS A total 62 patients treated with PCI were randomly divided into normal group and adenosine group. Corrected thrombolysis in myocardial infarction frame count (cTFC) post-PCI was taken as the criterion and no-reflow was set at cTFC≥23. Before and after PCI, CK-MB and hsCRP were detected and the incidence of no-reflow and the changes of plasma myocardial enzyme and inflammation factors in the two groups were compared. RESULTS The incidence of no-reflow in the adenosine group was obviously lower than that in the normal group (P<0.05). CK-MB and hs-CRP in the normal group was higher than those in the adenosine group (P<0.05). Multivariate line regression analysis showed a prominent correlation between the no-reflow and CK-MB and hsCRP (P<0.05). CONCLUSION The intracoronary injections of adenosine in patients with AMI effectively decreases no-reflow and the levels of myocardial enzyme and inflammation factors. |
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