摘要
目的:观察Rho激酶抑制剂法舒地尔对急性冠脉综合征(ACS )介入术后无复流的临床疗效。方法:住院行经皮冠状动脉介入(PCI)治疗后发生无复流的 ACS患者(82例)被随机分为法舒地尔组(30例,法舒地尔5mg),硝酸甘油组(25例,硝酸甘油200μg),替罗非班组(27例,替罗非班10ml),均在冠状动脉内注射药物,10min后复查冠脉造影并评定冠状动脉血流速度。观察TIMI血流改善情况、ST 段抬高及压低幅度、左室射血分数(LVEF)、主要不良心血管事件(MACE)发生率及并发症情况。结果:与硝酸甘油组比较,法舒地尔及替罗非班TIMI血流改善有效率(40.0%比63.3%、59.3%)、ST段抬高及压低幅度[(0.15±0.09) mm比(0.24±0.11) mm、(0.26±0.15) mm]、LVEF水平[(48.32±5.67)%比(56.12±7.11)%、(55.78±6.99)%]明显提高, MACE发生率明显下降, P<0.05-<0.01;在低血压、出血及血小板减少并发症方面,法舒地尔组并发症发生率(13.3%、6.7%、16.7%)均显著低于硝酸甘油组(68.0%、4.0%、12.0%)或替罗非班组(3.7%、29.6%、44.4%), P均<0.05。结论:法舒地尔治疗急性冠脉综合征介入术后无复流是安全有效的,值得推广。
Objective:To observe the clinical therapeutic effect of Rho kinase inhibitor-fasudil on no-reflow in pa-tients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) .Methods :A total of 82 ACS patients ,who hospitalized and occurred no-reflow after PCI ,were randomly divided into fasudil group (n=30 , received fasudil 5mg) ,nitroglycerin group (n=25 ,received nitroglycerin 200μg) and tirofiban group (n=27 ,re-ceived tirofiban 10ml) .All patients received drugs via intracoronary injection ,and reviewed coronary angiography and coronary blood flow velocity evaluation after 10min .Thrombolysis in myocardial infarction (TIMI) flow im-provement ,ST segment elevation/depression extent ,left ventricular ejection fraction (LVEF) ,incidence rates of major adverse cardiovascular events (MACE) and complications were observed .Results:Compared with nitroglycer-in group ,there were significant rise in effective rate of TIMI flow improvement (40.0% vs .63.3% ,59.3% ) ,ST segment elevation and depression extent [ (0.15 ± 0.09) mm vs .(0.24 ± 0.11) mm ,(0.26 ± 0.15) mm] and LVEF level [(48.32 ± 5.67)% vs .(56.12 ± 7.11)% ,(55.78 ± 6.99)% ] ,and significant reduction in incidence rate of MACE in fasudil group and tirofiban group , P〈0.05- 〈0.01 ;for complications of hypotension ,hemorrhage and thrombocytopenia ,incidence rates of fasudil group (13.3% ,6.7% ,16.7% ) were significantly lower than those of nitroglycerin group (68.0% ,4.0% ,12.0% ) or tirofiban group (3.7% ,29.6% ,44.4% ) , P〈0.05 all .Conclu-sion:Fasudil is safe and effective on no-reflow after PCI in ACS patients ,and it is worthy of extension .
出处
《心血管康复医学杂志》
CAS
2014年第5期526-530,共5页
Chinese Journal of Cardiovascular Rehabilitation Medicine
基金
延安大学附属医院专项科研基金重点项目(2012YDFY-Y202)~~
关键词
冠状动脉疾病
血流速度
法舒地尔
Coronary artery disease
Blood flow velocity
Fasudil