冠脉内注射硝酸甘油与维拉帕米对冠心病PCI术中慢血流和无复流的影响

目的:比较分析冠脉内注射硝酸甘油与维拉帕米对冠心病经皮冠状动脉介入术(PCI)中慢血流及无复流的影响.方法:以本院2014年2月~2016年2月行PCI术中发生慢血流、无复流患者78例为研究对象,根据不同给药方式将其分为硝酸甘油组与维拉帕米组,比较两组治疗前后冠脉TIMI分级、TIMI帧数、血压变化情况,同时统计两组住院期间、PCI术后30d不良心血管事件发生率.结果:两组治疗后IMI分级较治疗前显著上升,RCA、LAD、校正LAD、LCX帧数则显著下降,差异有统计学意义,维拉帕米组治疗后上述指标均显著优于硝酸甘油组;两组治疗前后血压无显著变化;硝酸甘油组住院期间、术后30d不良心血管事件发生率分别为17.07%、21.95%,均显著高于维拉帕米组的2.70%、5.40%,差异有统计学意义.结论:冠脉内注射硝酸甘油、维拉帕米均能有效改善冠心病PCI术中慢血流、无复流现象,但后者效果更明显,且能明显降低住院期间及术后30d不良心血管事件发生率.

Effect of coronary injection of nitroglycerin and verapamil on slow blood flow and no reflow during PCI of coronary heart disease

Objective To compare the effects of coronary injection of nitroglycerin and verapamil on slow blood flow and no reflow during percutaneous coronary intervention (PCI) of coronary heart disease. Methods Seventy-eight patients with slow blood flow and no reflow during PCI in our hospital between February 2014 and February 2016 were studied. According to the different ways of administration, they were divided into nitroglycerin group and verapamil group. The coronary TIMI grade, TIMI frames and changes of blood pressure were compared between the two groups before and after treatment. The length of stay and the incidence rate of adverse cardiovascular events in 30d after PCI in the two groups were statistically analyzed. Results After treatment, IMI grade in both groups were significantly higher than those before treatment while RCA, LAD, corrected LAD and LCX frames were significantly lower, the above indexes in verapamil group after the treatment were better than those in nitro-glycerin group; There was no significant change in blood pressure before and after treatment in the two groups; The incidence rates of adverse cardiovascular events in nitroglycerin group during hospitalization and in 30d after PCI (17.07%, 21.95%) were significantly higher than those in verapamil group (2.70%, 5.40%). Conclusion Coronary injection of neither nitroglycerin nor verapamilcan effectively relieve slow flow and no-reflow phenomenon during PCI of coronary heart disease, but effect of the lat-ter effect is more obvious and it can significantly reduce the incidence of adverse cardiovascular events during hospitalization and in 30d after PCI.