STEMI患者PCI术中注射前列地尔对心肌灌注恢复的影响

目的 探讨在急性ST段抬高型心肌梗死患者经皮冠状动脉介入术中注射前列地尔对患者心功能、心肌灌注、氧化应激和预后的影响.方法 将78例急性S T段抬高型心肌梗死患者按随机数字表法分为两组,各39例.两组均予以经皮冠状动脉介入术和常规支持治疗,观察组在术中冠脉注射前列地尔.比较两组术后梗死相关动脉心肌梗死溶栓试验血流分级和...

Effect of intracoronary injection of alprostadil on the recovery of myocardial perfusion in patients with STEMI during PCI

Objective To investigate the effects of coronary injection of alprostadil on cardiac function,myocardial perfusion,oxidative stress and prognosis in patients with acute ST-segment elevation myocardial infarction(STEMI)during percutaneous transluminal coronary intervention(PCI).Methods A total of 78 patients with STEMI were divided into two groups according to the random number table method,with 39 cases in each group.Both groups received PCI and conventional supportive treatment.The observation group received intraoperative coronary injection of alprostadil.Compare the postoperative infarct-related artery(IRA)thrombolysis in myocardial infarction(TIMI)blood flow classification and myocardial perfusion classification between the two groups.Compare the incidence of no-reflow phenomenon(NRP),slow reflow phenomenon(SRP),ST-segment fall rate,heart function recovery and oxidative stress index levels.The incidence of adverse cardiac events in the two groups was counted after 3 months of follow-up.Results(1)The ratio of TIMI myocardial perfusion grade(TMPG)grade 3 blood flow and ST-segment fall rate in observation group were significantly higher than those in control group(P<0.05),and the incidence rates of NRP and SRP were significantly lower than those in control group(P<0.05),and there was a statistically significant difference in the TIMI blood flow grading between the two groups(P<0.05).(2)The left ventricular end-diastolic dimension(LVEDD)and wall motion score index(WMSI)of the two groups were significantly lower than before operation(P<0.05),and the left ventricular ejection fraction(LVEF)was significantly higher than that before operation(P<0.05).The left ventricular end-diastolic dimension(LVEDD)and WMSI of the observation group were significantly lower than those of the control group,and LVEF was significantly higher than that of the control group(P<0.05).(3)Compared with before operation,the serum creatinine(SCr)and superoxide dismutase(SOD)levels of the observation group were significantly increased(P<0.05),and the malondialdehyde(MDA)levels were significantly reduced(P<0.05).The SCr and MDA levels in the control group were significantly increased(P<0.05),and the SOD level was significantly reduced(P<0.05).The SCr and MDA levels in the observation group were significantly lower than those of the control group(P<0.01),and the SOD level was significantly higher than that of the control group(P<0.01).(4)After 3 months of follow-up,although the incidence of adverse cardiac events in the observation group was lower than that in the control group,the difference was not statistically significant(P>0.05).Conclusions In the treatment of STEMI patients with PCI,coronary injection of alprostadil can improve the recovery level of IRA blood perfusion,reduce the occurrence of NRP or SRP after coronary recanalization,reduce the body’s oxidative stress response,and promote the improvement of cardiac function,and it creates good conditions for improving the prognosis of patients.