| 侯霁芯,阚竞宇,王 丹,刘 森,刘家欣,万进东,王沛坚.维拉帕米对急性前壁心肌梗死行急诊PCI术患者再灌注室性心律失常的影响[J].,2018,(8):1523-1526 |
| 维拉帕米对急性前壁心肌梗死行急诊PCI术患者再灌注室性心律失常的影响 |
| Effects of Verapamil on Reperfusion Ventricular Arrhythmias in Patients with Acute Anterior Myocardial Infarction Undergoing Percutaneous Coronary Intervention |
| 投稿时间：2017-08-14 修订日期：2017-08-28 |
| DOI：10.13241/j.cnki.pmb.2018.08.025 |
| 中文关键词: 急性心肌梗死 维拉帕米 再灌注心律失常 主要不良心血管事件 经皮冠状动脉介入治疗 |
| 英文关键词: Acute Anterior Myocardial Infarction Verapamil Reperfusion Ventricular Arrhythmias Major Adverse Cardiovascular Events Percutaneous Coronary Intervention |
| 基金项目:国家自然科学基金项目（81400289，81641058）；四川省杰出青年基金资助计划项目（2016JQ0032）；四川省卫生厅科研项目（150047）；四川省教育厅重点项目（16ZA0277）；四川省医学会科研项目（S15022）；成都医学院科研创新团队项目（16Z132） |
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| 中文摘要: |
| 摘要 目的：探讨经指引导管早期应用维拉帕米对急性前壁心肌梗死行急诊经皮冠状动脉介入治疗术（Percutaneous Coronary Intervention，PCI）患者再灌注室性心律失常的影响。方法：采用单中心、随机对照、前瞻性研究方法。选取2014年5月-2016年11月诊断为急性前壁心肌梗死并于我院行急诊PCI的患者，共纳入162例患者，按随机方法（随机数字表）分成2组，其中治疗组82例，对照组80例。治疗组患者在首次球囊扩张后早期经指引导管内给予维拉帕米（200 μg），对照组患者则给予生理盐水。观察再灌注后室性心律失常发生率，PCI术后冠脉血流情况，心肌梗死相关血清指标（CK-MB，cTnI）的峰值，住院期间发生的主要不良心血管事件（MACE）。结果：维拉帕米治疗组患者再灌注心律室性失常及无复流的发生率显著低于生理盐水对照组（P <0.05）；维拉帕米治疗组患者cTnI和CK-MB峰值分别为（46.63±13.77）μg/L和（139.87±35.45）U/L，生理盐水组cTnI和CK-MB峰值为（54.36±12.59）μg/L和（158.34±40.18）U/L，两组比较，P均 ＜0.01。MACE事件两组间未见有统计学差异。结论：急性前壁心肌梗死患者急诊PCI术前经导管早期给予维拉帕米不但可显著减少无复流现象，还可显著减少再灌注后室性心律失常的发生，住院期间MACE事件的发生率无显著性差异。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of verapamil on ventricular arrhythmias in patients with acute anterior myocardial infarction undergoing percutaneous coronary intervention. Methods: This is a single center, randomized controlled, single blind, prospective study. The patients with acute anterior myocardial infarction (From May 2014 to November 2016) were randomly divided into two groups, including the treatment group (Verapamil, n =82) and the control group (Saline, n = 80). The patients in the treatment group were given Verapamil (200 μg) through guiding catheter after the first balloon dilatation, while the control group was given saline. The incidence of ventricular arrhythmias after reperfusion, coronary blood flow after PCI, The peak level of myocardial injury markers and Major Adverse Cardiovascular Events(MACE) during hospitalization were observed. Results: The incidence of ventricular arrhythmia and no-reflow in the Verapamil treatment group was significantly lower than that in saline control group, P<0.05. The peak value of cTnI and CK-MB in the treatment group were （46.63±13.77）μg/L and（139.87±35.45）U/L, and the peak value of cTnI and CK-MB in saline group were （54.36±12.59）μg/L and（158.34±40.18）U/L, P <0.01. Conclusion: Patients suffered acute anterior myocardial infarction treated with Verapamil before the operation of PCI in the early stage can reduce the phenomenon of no reflow, but also can significantly reduce the occurrence of ventricular arrhythmias significantly. There was no significant difference in the incidence of MACE during hospitalization. |
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