Khoshnood Ardavan, Akbarzadeh Mahin, Carlsson Marcus, Sparv David, Bhiladvala Pallonji, Mokhtari Arash, Erlinge David, Ekelund Ulf
a Department of Clinical Sciences, Emergency and Internal Medicine , Lund University, Skåne University Hospital , Lund , Sweden.
b Department of Clinical Sciences, Clinical Physiology , Lund University, Skåne University Hospital , Lund , Sweden.
Scand Cardiovasc J. 2018 Apr;52(2):69-73. doi: 10.1080/14017431.2018.1439183. Epub 2018 Feb 13.
Oxygen (O) have been a cornerstone in the treatment of acute myocardial infarction. Studies have been inconclusive regarding the cardiovascular and analgesic effects of oxygen in these patients. In the SOCCER trial, we compared the effects of oxygen treatment versus room air in patients with ST-elevation myocardial infarction (STEMI). There was no difference in myocardial salvage index or infarct size assessed with cardiac magnetic resonance imaging. In the present subanalysis, we wanted to evaluate the effect of O on chest pain in patients with STEMI.
Normoxic patients with first time STEMI were randomized in the ambulance to standard care with 10 l/min O or room air until the end of the percutaneous coronary intervention (PCI). The ambulance personnel noted the patients´ chest pain on a visual analog scale (VAS; 1-10) before randomization and after the transport but before the start of the PCI, and also registered the amount of morphine given.
160 patients were randomized to O (n = 85) or room air (n = 75). The O group had a higher median VAS at randomization than the air group (7.0 ± 2.3 vs 6.0 ± 2.9; p = .02) and also received a higher median total dose of morphine (5.0 mg ± 4.4 vs 4.0 mg ± 3.7; p = .02). There was no difference between the O and air groups in VAS at the start of the PCI (4.0 ± 2.4 vs 3.0 ± 2.5; p = .05) or in the median VAS decrease from randomization to the start of the PCI (-2.0 ± 2.2 vs -1.0 ± 2.9; p = .18).
Taken together with previously published data, these results do not support a significant analgesic effect of oxygen in patients with STEMI. European Clinical Trials Database (EudraCT): 2011-001452-11. ClinicalTrials.gov Identifier: NCT01423929.
氧气一直是急性心肌梗死治疗的基石。关于氧气对这些患者的心血管和镇痛作用的研究尚无定论。在SOCCER试验中，我们比较了氧气治疗与室内空气对ST段抬高型心肌梗死（STEMI）患者的影响。通过心脏磁共振成像评估的心肌挽救指数或梗死面积没有差异。在本次亚分析中，我们想评估氧气对STEMI患者胸痛的影响。
首次发生STEMI的常氧患者在救护车上被随机分为接受10升/分钟氧气的标准治疗或室内空气治疗，直至经皮冠状动脉介入治疗（PCI）结束。救护人员在随机分组前、转运后但在PCI开始前，用视觉模拟量表（VAS；1 - 10）记录患者的胸痛情况，并记录给予吗啡的剂量。
160例患者被随机分为氧气组（n = 85）或室内空气组（n = 75）。氧气组随机分组时的VAS中位数高于空气组（7.0 ± 2.3对6.0 ± 2.9；p = 0.02），且接受的吗啡总剂量中位数也更高（5.0毫克± 4.4对4.0毫克± 3.7；p = 0.02）。在PCI开始时，氧气组和空气组的VAS没有差异（4.0 ± 2.4对3.0 ± 2.5；p = 0.05），从随机分组到PCI开始时VAS中位数的下降也没有差异（-2.0 ± 2.2对-1.0 ± 2.9；p = 0.18）。
结合先前发表的数据，这些结果不支持氧气对STEMI患者有显著镇痛作用。欧洲临床试验数据库（EudraCT）：2011 - 001452 - 编11。ClinicalTrials.gov标识符：NCT01423929。
