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目的观察前列地尔对急性心肌梗死经皮冠状动脉介入(PCI)术后心肌灌注的影响。方法将120例急性心肌梗死行PCI治疗患者随机分为前列地尔组与对照组各60例。对照组患者入院后90min内给予PCI治疗,术前给予双联抗栓、阿托伐他汀钙治疗。前列地尔组在对照组治疗基础上于术前及术后各给予前列地尔治疗。比较2组患者治疗前后靶血管TIMI血流分级与TIMI心肌灌注分级(TMP),观察2组患者心电图ST段回落幅度。结果 2组PCI术前TIMI血流分级、心肌灌注分级(TMPG)比较差异无统计学意义(P>0.05)。PCI术后,2组TIMI血流分级和心肌灌注分级均优于PCI术前,且前列地尔组PCI术后TIMI血流分级、心肌灌注分级均优于对照组,差异有统计学意义(P<0.05)。前列地尔组心电图ST段回落幅度为(69.04±10.47)%高于对照组的(58.26±11.04)%,差异有统计学意义(P<0.05)。结论急性心肌梗死患者行PCI治疗前后给予前列地尔治疗可明显改善冠脉血流,增加心肌血流灌注,减少心肌坏死组织范围。
Objective To observe the effect of prostaglandin on myocardial perfusion after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction. Methods 120 patients with acute myocardial infarction undergoing PCI were randomly divided into alprostadil group and control group of 60 patients. Patients in the control group were given PCI within 90 minutes after admission, and received double antithrombotic therapy and atorvastatin calcium before operation. The alprostadil group was given alprostadil preoperatively and postoperatively on the basis of the control group. The TIMI flow classification and TIMI myocardial perfusion grading (TMP) were compared between the two groups before and after treatment, and the decline range of ECG ST segment in two groups was observed. Results There were no significant differences in TIMI flow classification and myocardial perfusion grading (TMPG) between the two groups before PCI (P> 0.05). After PCI, the TIMI flow classification and myocardial perfusion grading were superior to those before PCI in both groups, and TIMI flow classification and myocardial perfusion grading in the alprostadil group were superior to the control group (P <0.05). In the alprostadil group, the ST segment decline rate was (69.04 ± 10.47)% higher than that in the control group (58.26 ± 11.04)%, with significant difference (P <0.05). Conclusions Alprostadil treatment before and after PCI in patients with acute myocardial infarction can improve coronary blood flow, increase myocardial perfusion, and reduce the range of myocardial necrosis.