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目的 探讨冠状动脉内注射腺苷对急性心肌梗死急诊直接PTCA术中无再流现象发生的影响.方法79例急性心肌梗死患者被随机分配到腺苷组(51例)和非腺苷组(28例),腺苷给药方法为在每次球囊扩张前及其后冠状动脉内弹丸式注射24～48 μg.结果非腺苷组有8例出现无血流(28.6%),腺苷组有3例出现无血流(5.9%).注射腺苷患者未见明显合并症.结论对于急性心肌梗死患者,急诊PTCA术中冠状动脉内注射腺苷安全有效,无再流发生率显著降低,因此对改善患者预后具有极为重要的意义.“,”Aim To investigate the role of intracoronary adenosine for the prevention of no reflow. Methods The procedural outcomes of 79 patients who undertook percutaneous intervention in the setting of acute myocardial infarction was studied. Twenty-eight patients did not received intracoronary adenosine ,and fifty-one received intracoronary adenosine bolluses (24-48 μg before and after each balloon inflation). Results Eight patients who were not given adenosine experienced no reflow (28.6%) and high in-hospital death rate, three of fifty-one patients (5.9%) in the adenosine group experienced no reflow. No untoward complications were noted during adenosine infusion. Conclusion Intracoronary adenosine bolus administration during percutaneous intervention in the patients with acute myocardial infarction is easy and safe and may significantly lessen the incidence of no reflow and may improve the outcome of this procedure.