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目的探讨冠脉介入术中发生无复流及慢血流时各种药物处理对改善TIMI血流的影响。方法选取行PCI治疗的ACS患者91例,分为正常血流组、无复流组及慢血流组。通过比较三组病例的基本资料来阐明其发生的相关影响因素,在术中发生无复流及慢血流时给予对症药物处理,分析各种干预方法对血流改善的影响。结果前降支发生慢血流几率显著高于无复流组(P<0.05),右冠发生无复流几率高于慢血流组(P<0.05)。慢血流组,硝酸甘油对血流明显改善(P<0.01),硝普钠血流改善方面有统计学意义(P<0.05)。联合药物治疗两组之间有显著差异(P<0.01);无复流组,硝普钠对血流明显改善(P<0.01),联合药物治疗两组之间有统计学差异(P<0.05);硝酸甘油对于慢血流改善优于无复流(P<0.01),硝普钠方面无复流组改善优于慢血流组有统计学意义(P<0.05)。给予联合药物治疗无复流组血流改善优于慢血流组(P<0.01)。在给予欣维宁方面,无复流组优于慢血流组,有统计学意义(P<0.05)。结论硝酸甘油能有效改善冠脉慢血流发生,而硝普钠对冠脉无复流疗效佳,但如使用上述药物效果不明显时联合用药对血流改善明显。
Objective To investigate the effects of various drug treatments on the improvement of TIMI blood flow in patients undergoing coronary intervention without recurrence and slow blood flow. Methods Ninety-one ACS patients undergoing PCI were divided into two groups: normal blood flow group, no-reflow group and slow blood flow group. By comparing the basic data of three groups of patients to clarify the related factors of its occurrence, the treatment of symptomatic drugs during no-reflow and slow blood flow during operation occurred, and analyzed the impact of various intervention methods on blood flow improvement. Results The incidence of slow blood flow in the anterior descending artery was significantly higher than that in the no-reflow group (P <0.05). The probability of no-reflow in the right coronary artery was higher than that in the slow blood flow group (P <0.05). Slow blood flow group, nitroglycerin significantly improved blood flow (P <0.01), and improved sodium nitroprusside blood flow (P <0.05). There was a significant difference between the two groups (P <0.01). The no-reflow group and sodium nitroprusside significantly improved the blood flow (P <0.01), and there was a significant difference between the two groups ); Nitroglycerin was superior to no-reflow for the improvement of slow blood flow (P <0.01), no improvement of no-reflow group for sodium nitroprusside was better than the slow-flow group (P <0.05). The improvement of blood flow in the no-reflow group was better than that in the slow-flow group (P <0.01). In the aspect of giving Shenweinin, no-reflow group was better than the slow blood-flow group, with statistical significance (P <0.05). Conclusion Nitroglycerin can effectively improve the occurrence of coronary blood flow, while sodium nitroprusside has no effect on coronary artery no-reflow. However, when the effect of the above drugs is not obvious, the combination therapy can significantly improve the blood flow.