Ishihara M, Sato H, Tateishi H, Kawagoe T, Shimatani Y, Kurisu S, Sakai K
Department of Cardiology, Hiroshima City Hospital, Japan.
Am Heart J. 1996 Nov;132(5):959-63. doi: 10.1016/s0002-8703(96)90005-8.
The no-reflow phenomenon is observed as reduction of coronary blood flow on the angiograms (angiographic no-reflow) after immediate percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI). To assess whether a potent coronary microvascular dilator--papaverine--could attenuate the no-reflow phenomenon, nine patients with AMI who were found to have angiographic no-reflow after PTCA were studied. Angiographic no-reflow was defined as the Thrombolysis in Myocardial Infarction flow grade 1 or 2 without any mechanical obstructions in the epicardial artery. A bolus dose of 10 mg of intracoronary papaverine was administered, and the flow grade was again evaluated. Intracoronary papaverine caused a significant improvement of the flow grade (p= 0.0152). The number of cineframes that were required for the contrast medium to pass two selected landmarks on the angiograms also significantly decreased (41 +/- 17 frames to 18 +/- 8 frames, p= 0.0039). Thus intracoronary papaverine attenuated angiographic no-reflow that occurred after PTCA for AMI.
无复流现象表现为急性心肌梗死（AMI）患者在直接经皮腔内冠状动脉成形术（PTCA）后血管造影显示冠状动脉血流减少（血管造影无复流）。为评估强效冠状动脉微血管扩张剂罂粟碱是否能减轻无复流现象，对9例PTCA后出现血管造影无复流的AMI患者进行了研究。血管造影无复流定义为心肌梗死溶栓血流分级为1级或2级，且心外膜动脉无任何机械性梗阻。给予10 mg冠状动脉内罂粟碱推注剂量，再次评估血流分级。冠状动脉内罂粟碱使血流分级显著改善（p = 0.0152）。造影剂通过血管造影上两个选定标记所需的电影帧数也显著减少（从41±17帧降至18±8帧，p = 0.0039）。因此，冠状动脉内罂粟碱减轻了AMI患者PTCA后出现的血管造影无复流。
