地尔硫（艹卓）对急性心肌梗死患者急诊冠状动脉介入治疗中无再流的作用

Objective To assess the effects of intracoronary diltiazem on no-reflow phenomenon of infarct-related artery (IRA) after emergent percutaneous transluminal coronary angioplasty or/and intracoronary stenting (PTCA/Stenting) in the patients with acute myocardial infarction (AMI). Methods We studied 34 AMI patients with no-reflow phenomenon of IRA after emergent PTCA/Stenting between January 1999 and August 2005. Urokinase-treated group (n=16) was given intracoronary urokinase 300 000~500 000 units within 15~30 minutes between January 1999 and April 2002 while diltiazemtreated group (n=18) was given intracoronary diltiazem 0.5~2 mg within 10~30 minutes between May 2002 and August 2005. Fifteen minutes later, coronary arteriography (CAG) was performed and the thrombolysis in myocardial infarction (TIMI) flow grade was measured. Results No apparent change of TIMI flow grade was found between pre-administration and post-administration of intracoronary urokinase, but TIMI flow grade was significantly improved after intracoronary diltiazem (P＜0.01). TIMI flow grade of diltiazem-treated group was significantly higher than that of urokinase-treated group after the administration (P＜0.05). The percentage of the patients who reached TIMI flow grade 3 after the intracoronary administration was higher in the diltiazem-treated group than that in the urokinase-treated group (P＜0.01). Conclusion The intracoronar administration of diltiazem 0.5~2 mg can effectively improve the no-reflow phenomenon after emergent PTCA/Stenting in patients with AMI.