冠状动脉内注射乌拉地尔对急性心肌梗死心肌灌注和心功能的影响

目的:探讨乌拉地尔对急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)患者心肌灌注和心功能的影响。方法:对经急诊PCI治疗的AMI患者54例,随机分为乌拉地尔组、硝酸甘油组和对照组。分别于经皮腔内冠状动脉成形术前冠状动脉内注射乌拉地尔、硝酸甘油、生理盐水。观察PCI术前、术后心肌梗死溶栓试验(TIMI)血流、校正的TIMI帧计数(cTFC)、心肌充血分级(MBG)、ST段回落、心肌坏死指标、左心室射血分数(LVEF)及住院期间主要心血管不良事件(MACE)。结果:乌拉地尔组与硝酸甘油组和对照组相比,PCI后cTFC降低、MBG增加、ST段回落增加、LVEF增加、CK和TnT峰值降低(P均<0.01)。结论:乌拉地尔可改善AMI急诊PCI患者冠状动脉血流、心肌灌注和左心室收缩功能,减少梗死面积,不增加住院期间MACE。

Beneficial effects of intracoronary urapidil as an adjunct to primary angioplasty in acute myocardial infarction

Objective:The aim of this study was to evaluate the effect of urapidil on myocardial reperfusion and heart function during primary percutenous coronary intervention(PCI)in acute myocardial infarction(AMI)patients.Method:Fifty and four AMI patients undergoing primary PCI were randomized to intracoronary urapidil,nitroglycerin or saline group.Before percutenous transluminal coronary angioplasty,urapidil,nitroglycerin or saline were given intracoronary and then stents were implanted as needed.TIMI blood flow,corrected TIMI frame count,myocardial blush grade,ST resolution on ECG,left ventricular eject fraction,major adverse cardiac events were observed.Result:Final TIMI blood flow,cTFC and MBG improved in the urapidil group(compared to the nitroglycerin and control group,P<0.01,respectively).ST resolution in the urapidil group was more significant than that of the nitroglycerin and control group(P<0.01,respectively).LVEF in the urapidil group was higher than that of the nitroglycerin and control group(P<0.01).Conclusion:Conclusions:Intracoronary urapidil administration adjunct to primary PCI in AMI ameliorates coronary blood flow and myocardial perfusion,improves ventricular function,and is associated with a more favorable clinical course.