摘要
对于急性冠脉综合征(ACS)患者,直接经皮冠状动脉介入(PCI)治疗是目前最为显著的治疗手段。但梗死相关动脉(IRA)的开通并不意味着血流灌注的恢复。有研究表明,接受PCI术血管再通治疗的患者中有5%～50%出现慢血流及无复流(NR/SF)现象^([1])。目前,对于NR/SF的治疗,包括冠脉内注射腺苷、冠脉内注射硝普钠、冠脉内注射维拉帕米、术前及术中使用替罗非班等药物治疗,以及缺血预处理和后处理、血栓抽吸及远端保护装置等非药物措施。但目前为止,没有一种药物或器械可以完全预防NR/SF的发生^([2])。近年来,尼可地尔作为一种可以改善心肌微循环的药物受到关注,本篇通过搜索Pubmed、EMBASE、CBM、CNKI、万方数据库及维普数据库公开发表的相关文献,对PCI术中NR/SF的防治及在急诊PCI术围手术期,给予尼可地尔对ACS患者PCI术中NR/SF的影响及远期的心脏保护作用的评价作一综述。
Primary percutaneous coronary interventions(PCI) are the best available reperfusion strategies for patients with acute coronary syndrome(ACS). Despite re-establishing the epicardial coronary vessel patency, primary PCI may fail to restore optimal myocardial reperfusion within myocardial tissue. Studies have shown that 5% to 50% of patients undergoing PCI recanalization therapy have slow flow and no reflow(NR/SF) phenomenon. Some methods, such as intracoronary adenosine, intracoronary nitroprusside, intracoronary verapamil or tirofiban, ischaemic post-conditioning, thrombus aspiration, and/or distal filters, have been used for prevention or treatment of NR/SF. At present, no drug or device can completely prevent NR/SF. In recent years, more attention has been paid to nicorandil as it can improve micro-circulation of the myocardium. In this article, we review the beneficial effects of niconrandil for NO-Reflow phenomenon in ACS patients during PCI and its prognostic significance.
作者
李秋朋
贺媛
陈迈
LI Qiu-peng;HE Yuan;CHEN Mai(Department of Caidiovasculogy, First Affiliated Hospital, Air Force Medical University, Xi'an 710032, Shaanxi,China)
出处
《心脏杂志》
CAS
2019年第2期222-226,231,共6页
Chinese Heart Journal
