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目的:探讨乌拉地尔对急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)患者心肌灌注和心功能的影响。方法:对经急诊PCI治疗的AMI患者54例,随机分为乌拉地尔组、硝酸甘油组和对照组。分别于经皮腔内冠状动脉成形术前冠状动脉内注射乌拉地尔、硝酸甘油、生理盐水。观察PCI术前、术后心肌梗死溶栓试验(TIMI)血流、校正的TIMI帧计数(cTFC)、心肌充血分级(MBG)、ST段回落、心肌坏死指标、左心室射血分数(LVEF)及住院期间主要心血管不良事件(MACE)。结果:乌拉地尔组与硝酸甘油组和对照组相比,PCI后cTFC降低、MBG增加、ST段回落增加、LVEF增加、CK和TnT峰值降低(P均<0.01)。结论:乌拉地尔可改善AMI急诊PCI患者冠状动脉血流、心肌灌注和左心室收缩功能,减少梗死面积,不增加住院期间MACE。
Objective: To investigate the effect of urapidil on myocardial perfusion and cardiac function in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Methods: Fifty-four AMI patients treated by emergency PCI were randomly divided into Urapidil group, nitroglycerin group and control group. Percutaneous intraluminal coronary angioplasty prior to intracoronary injection of urapidil, nitroglycerin, saline. The TIMI flow, corrected TIMI frame count (cTFC), myocardial infarction grade (MBG), ST segment depression, myocardial necrosis index, left ventricular ejection fraction (LVEF) And major cardiovascular adverse events (MACE) during hospitalization. Results: Compared with nitroglycerine group and control group, the cTFC decreased, MBG increased, the ST segment decreased, LVEF increased and the peak of CK and TnT decreased (P <0.01). CONCLUSIONS: Urapidil improves coronary blood flow, myocardial perfusion, and left ventricular systolic function in AMI emergency PCI patients, decreases infarct size, and does not increase MACE during hospitalization.