Kent K M, Cleman M W, Cowley M J, Forman M B, Jaffe C C, Kaplan M, King S B, Krucoff M W, Lassar T, McAuley B
Cardiology Division, Georgetown University Medical Center, Washington, DC 20007.
Am J Cardiol. 1990 Aug 1;66(3):279-84. doi: 10.1016/0002-9149(90)90836-p.
The effects of perfusion of an oxygen-carrying perfluorochemical emulsion (Fluosol) in alleviating symptoms of myocardial ischemia during balloon occlusion were examined in a multicenter trial of 245 patients. Severe anginal pain occurred less frequently in patients receiving Fluosol perfusion (21%) than in those receiving routine angioplasty (34%) (p less than 0.05). ST-segment changes at balloon deflation in routine angioplasty patients were significantly greater than in patients who received oxygenated Fluosol perfusion (2.2 +/- 1.2 vs 1.7 +/- 0.9 mm; p less than 0.03). Profound regional wall dysfunction (-561 +/- 224 U) was observed in routine angioplasty patients by 2-dimensional echocardiography. Patients receiving oxygenated Fluosol perfusion, however, maintained near baseline levels of ventricular function (-61 +/- 335 U) during occlusion (p less than 0.0001). Mean global left ventricular ejection fraction was preserved at baseline levels during balloon inflation in patients perfused with oxygenated Fluosol but decreased significantly (p less than 0.001) during occlusion in routine angioplasty patients. A total of 26 complications (19 routine group; 7 perfusion group) was reported. Adverse responses to the perfusate were infrequent, occurring in 1.6 and 2.0% of patients after the test dose and during perfusion, respectively. Thus, transcatheter perfusion with an oxygen-carrying perfluorochemical emulsion is effective in alleviating myocardial ischemia during angioplasty and can be safely administered in this patient population.
在一项针对245例患者的多中心试验中，研究了携带氧的全氟化合物乳剂（氟碳乳剂）灌注在缓解球囊闭塞期间心肌缺血症状方面的作用。接受氟碳乳剂灌注的患者中，严重心绞痛的发生率（21%）低于接受常规血管成形术的患者（34%）（p<0.05）。常规血管成形术患者球囊放气时的ST段变化显著大于接受充氧氟碳乳剂灌注的患者（2.2±1.2 vs 1.7±0.9 mm；p<0.03）。通过二维超声心动图观察到，常规血管成形术患者出现了严重的局部室壁功能障碍（-561±224 U）。然而，接受充氧氟碳乳剂灌注的患者在闭塞期间心室功能维持在接近基线水平（-61±335 U）（p<0.0001）。在充氧氟碳乳剂灌注的患者中，球囊充盈期间左心室平均整体射血分数维持在基线水平，但在常规血管成形术患者闭塞期间显著降低（p<0.001）。共报告了26例并发症（常规组19例；灌注组7例）。对灌注液的不良反应很少见，分别在试验剂量后和灌注期间有1.6%和2.0%的患者出现。因此，经导管灌注携带氧的全氟化合物乳剂在血管成形术期间缓解心肌缺血有效，且在该患者群体中可安全给药。
