Clinical study of alprostadil injection in the treatment of patients with emergency percutaneous coronary intervention
10.3760/cma.j.issn.1673-4904.2013.33.009
- VernacularTitle:前列地尔脂微球注射液治疗急诊冠状动脉介入术患者的临床研究
- Author:
Rui QIAO
;
Mingwei WANG
- Publication Type:Journal Article
- Keywords:
Alprostadil;
Ventricular function,left;
Echocardiography;
Percutaneous coronary intervention;
Acute myocardial infarction
- From:
Chinese Journal of Postgraduates of Medicine
2013;36(33):26-29
- CountryChina
- Language:Chinese
-
Abstract:
Objective To research the clinical efficacy of alprostadil injection in treatment of patients with emergency percutaneous coronary intervention (PCI).Methods Eighty-five patients with acute myocardial infarction(AMI) were enrolled in this study,and they were randomly divided into treatment group (45 patients) and control group (40 patients).All patients were given 300 mg aspirin and 300 mg clopidogrel before operation,anti-platelet aggregation and long-term hpid regulation were given.On the basisof conventional treatment,0.9％ sodium chloride (NaCl) 100 ml and alprostadil injection 10 μ g were given in treatment group,2 times one day,a total of 14 d.After treatment for 1,6 months,the heart function and systohc function were assessed by echocardiography.High sensitive C reactive protein (hs-CRP),endothehn (ET)-1 and interleukin (IL)-6 were measured with ELISA,nitric oxide (NO) was measured with chromatometry.The basic clinical characteristic,inflammatory markers and major adverse cardiac events (MACE) were analyzed during in-hospital and follow-up period between two groups.Results The level of IL-6,hs-CRP,ET-1,NO in two groups had no significant difference before treatment and after treatment for 1 month (P ＞ 0.05).After treatment for 6 months,the level of IL-6,hs-CRP,ET-1,NO in treatment group had significant difference compared with that in control group [(1.04 ± 1.10) ng/L vs.(3.82 ± 1.34) ng/L,(1.5 ±1.2)mg/Lvs.(3.5 ±0.8) mg/L,(62.18 ± 20.22) ng/L vs.(85.56± 16.55) ng/L,(55.25 ± 8.25) μmol/L vs.(46.16 ±9.20) μ mol/L] (P ＜0.05).The level of left ventricular end-systolic volume (LVESV),left ventricular end-diastolic volume (LVEDV),left ventricular ejection fraction (LVEF) in two groups before treatment and after treatment for 1 month had no significant difference (P ＞ 0.05).After treatment for 6months,the level of LVESV,LVEDV in treatment group were significandy lower than those in control group [(82.5 ± 20.6) ml vs.(90.5 ± 20.1) ml,(130.5 ± 33.8) ml vs.(144.3 ± 28.6) ml],the level of LVEF was significantly higher than that in control group [(57.8 ±6.3)％ vs.(48.5 ±6.5)％],there was significant difference (P ＜ 0.05).The mortality rate and the incidence of MACE was 7.5％ (3/40),25.0％ (10/40)in control group,which were significantly higher than those in treatment group [4.4％ (2/45),13.3％ (6/45)],there were significant differences (P ＜0.05).The incidence of heart failure in control group was 22.5％(9/40),which was significantly higher than that in treatment group [11.1％(5/45)],there was significant difference (P ＜ 0.05).Conclusions Using alprostadil injection for patients with AMI after emergency PCI can prevent left ventricular remodeling,improve left ventricular function,and can reduce the incidence of MACE.Alprostadil injection can reduce the inflammatory reaction in patients with AMI,inhibit catecholamine release,inhibit platelet adhesion and aggregation,and stable plaques,reduce the incidence of MACE.
