梁振洋,刘美丽,赵雪东,李毅,王贺阳,赵昕,陶杰,王斌,聂绍平,韩雅玲

• 1:沈阳军区总医院心内科全军心血管病研究所
• 2:首都医科大学附属北京安贞医院急诊危重症中心

摘要(Abstract)：

目的探讨冠状动脉内注射比伐卢定预防急性ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者直接经皮冠状动脉介入治疗(primary percutaneous coronary intervention,PPCI)术中冠状动脉无复流或慢血流的作用。方法选取2015年7月至2015年12月沈阳军区总医院心内科及北京安贞医院急诊危重症中心收治的拟行PPCI的STEMI患者84例,以1∶1的比例随机分为对照组(不进行冠状动脉内注射比伐卢定,仅接受标准剂量静脉注射比伐卢定)40例和试验组(经冠状动脉内推注剂量为静脉负荷剂量50%的比伐卢定)44例。比较两组患者PPCI术后靶血管无复流或慢血流(TIMI血流≤Ⅱ级)的发生情况。结果对照组和试验组患者术中[25例(62.5%)比24例(54.5%),P=0.460]、术后[6例(15.0%)比6例(13.6%),P=0.428]无复流或慢血流(TIMI血流≤Ⅱ级)的发生率比较,差异均无统计学意义,且未发现与术后无复流或慢血流发生相关的危险因素。结论冠状动脉内应用比伐卢定在预防STEMI患者PPCI术中无复流或慢血流方面的获益并不明显,需要进一步探索合适的剂量,并进行大样本随机对照研究来验证。

关键词(KeyWords)： 比伐卢定;无复流;慢血流;急性ST段抬高心肌梗死;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation): 辽宁省自然科学基金指导计划项目(201602779)

作者(Author): 梁振洋,刘美丽,赵雪东,李毅,王贺阳,赵昕,陶杰,王斌,聂绍平,韩雅玲

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