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|本期目录/Table of Contents|

冠状动脉内注射腺苷对急性心肌梗死再灌注后无复流的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2009年第3期
页码:
371-374
栏目:
临床研究
出版日期:
2009-05-15

文章信息/Info

Title:
Effect of intracoronary injections of adenosine on no-reflow after reperfusion in acute myocardial infarction
作者:
李丹; 王祖锦; 王岚峰; 杨树森; 周立君; 修春红; 潘薇; 李竹琴
哈尔滨医科大学附属第一医院心内科，黑龙江 哈尔滨 150001
Author(s):
LI Dan;  WANG Zu-jin;  WANG Lan-feng;  YANG Shu-sen;  ZHONG Li-jun;  XIU Chun-hong;  PAN Wei;  LI Zhu-qin
Department of Cardiology, First Affiliated Hospital, Harbin Medical University, Harbin 150001, Heilongjiang, China
关键词:
腺苷; 心肌梗死; 急性; 无复流
Keywords:
adenosine;  acute myocardial infarction;  no-reflow
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 评价冠状动脉内注射腺苷对急性心肌梗死(AMI)再灌注治疗后无复流的影响。方法 共62例行经皮冠状动脉介入治疗（PCI）的AMI患者，被随机分为对照组和腺苷组。以PCI后最终冠脉造影校正的心肌梗死溶栓试验血流帧数（corrected thrombolysis in myocardial infarction frame count，cTFC）为标准，当cTFC≥23时诊断为无复流。PCI前、后采集肘静脉血检测肌酸激酶同工酶(CK-MB)和超敏C反应蛋白(hsCRP)。比较两组无复流发生率及血浆心肌酶和炎症因子的变化。结果 腺苷组中无复流的发生率较对照组明显降低(P<0.05)。腺苷组CK-MB和hsCRP较对照组明显降低(P<0.05)。多元线性回归分析显示CK-MB、hsCRP与无复流显著相关(P<0.05)。结论 AMI患者冠脉内应用腺苷能有效降低无复流的发生，降低血浆心肌酶、炎症因子水平。
Abstract:
AIM To evaluate the effect of intracoronary injections of adenosine on no-reflow after reperfusion in patients with acute myocardial infarction. METHORDS A total 62 patients treated with PCI were randomly divided into normal group and adenosine group. Corrected thrombolysis in myocardial infarction frame count (cTFC) post-PCI was taken as the criterion and no-reflow was set at cTFC≥23. Before and after PCI, CK-MB and hsCRP were detected and the incidence of no-reflow and the changes of plasma myocardial enzyme and inflammation factors in the two groups were compared. RESULTS The incidence of no-reflow in the adenosine group was obviously lower than that in the normal group (P<0.05). CK-MB and hs-CRP in the normal group was higher than those in the adenosine group (P<0.05). Multivariate line regression analysis showed a prominent correlation between the no-reflow and CK-MB and hsCRP (P<0.05). CONCLUSION The intracoronary injections of adenosine in patients with AMI effectively decreases no-reflow and the levels of myocardial enzyme and inflammation factors.

参考文献/References

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［3］ Marzilli M, Orsini E, Marraccini P, et al. Beneficial effects of intracoronary adenosine as an adjunct to primary angioplasty in acute myocardial infarction ［J］. Circulation, 2000, 101(18):2154-2159.

［4］ Gibson CM, Cannon CP, Daley WL, et al. TIMI frame count: a quantitative method of assessing coronary artery flow［J］. Circulation, 1996, 93(5):879-888.

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［7］ Hamada S, Nishiue T, Nakamura S, et al. TIMI frame count immediately after primary coronary angioplasty as a predictor of functional recovery in patients with TIMI 3 reperfused acute myocardial infarction［J］. J Am Coll Cardiol, 2001, 38(3):666-671.

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［9］ 赵季红,侯允天,张利华. 冠心病与炎症的关系以及C 反应蛋白新的临床意义［J］. 心脏杂志, 2001, 13(5):398-400.

［10］吴兆增,李梅,骆美瑛,等. 冠心病患者血清hs-CRP和M-CSF检测的临床意义［J］. 放射免疫学杂志, 2006, 19(4):291-292.

［11］杨春秀. 冠心病患者血清hs-CRP和E-Selectin检测的临床意义［J］. 放射免疫学杂志, 2007, 20(3):276-277.

［12］Mangoni ME, Barrère-Lemaire S. Adenosine receptors, heartrate, and cardioprotection［J］. Cardiovasc Res, 2004, 62(3):447-449.

备注/Memo

备注/Memo:
收稿日期：2008-9-19.基金项目：黑龙江省攻关课题项目资助（GC05C40302） 通讯作者：王岚峰，主任医师，主要从事心肌梗死的诊治研究Email:lanfengwang@hotmail.com 作者简介：李丹，住院医师，硕士Email:ld790425@126.com
更新日期/Last Update: 2009-05-18