尼可地尔对急性呼吸窘迫综合征患者的心肌保护作用  

Protective effect of nicorandil on myocardium in patients with acute respiratory distress syndrome

作　　者：刘兰[1] 叶八宁[1] 潘渝[1] 王宇辉[1] 胡远东[1] 李岑[1] 李健权[1] 成小蓉[1] 施贤清[1] 

机构地区：[1]贵州省人民医院重症医学科,贵阳550002

出　　处：《临床心血管病杂志》2015年第12期1311-1313,共3页Journal of Clinical Cardiology

基　　金：贵州省科技厅-贵州省人民医院联合基金(No:黔科合LS字[2012]025号)

摘　　要：目的:观察尼可地尔对急性呼吸窘迫综合征(ARDS)患者的心肌保护作用。方法:采用前瞻性随机对照研究方法,选择ARDS患者40例,随机分为治疗组(20例)和对照组(20例)。治疗组给予尼可地尔10 mg胃管注入3次/d,共5 d,余治疗两组相同。观察两组治疗前后超敏C反应蛋白(hs-CRP)、超敏心肌肌钙蛋白(hscTn)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及28 d病死率差异。结果:①两组患者性别、年龄、治疗前APACHEⅡ评分、hs-CRP及hs-cTn等基础状态无显著差异;②治疗后治疗组hs-CRP[11.35(3.63)g/L:13.50(5.93)g/L,P=0.027、hs-cTn[45.10(27.40)ng/L:65.70(74.58)ng/L,P=0.023较对照组明显降低;③治疗后两组APACHEⅡ评分[(21.05±8.58):(18.70±11.21)]及28 d死亡率(25%:15%)无统计学差异。结论:尼可地尔可减轻ARDS患者的心肌损害,保护心肌,但不能降低患者的28 d病死率。Objective：To observe the effect of nicorandil on myocardium in patients with acute respiratory distress syndrome（ARDS）.Method：A prospective controlled study was conducted.A total of 40 cases with ARDS were enrolled,and were randomly divided into treatment group（n=20） and control group（n = 20）.The treatment group was given intragastric administration of nicorandil 10 mg,3 times/day,a total of 5 days.The rest of treatments were same in the two groups.The blood high-sensitivity C-reactive protein（hs-CRP） levels,the blood high-sensitivity cardiac troponin（hs-cTn） levels,acute physiology and chronic health evaluation Ⅱ（APACHEⅡ） score and 28 day mortality were compared between two groups.Result：①There was no significantly difference in the basic state such as gender,age,hs-CRP[11.35（3.63）g/Lvs13.50（5.93） g/L,P = 0.027],hs-cTn[45.10（27.40） ng/L vs 65.70（74.58） ng/L,P = 0.023]and APACHE Ⅱ score between two groups.② After treatment,the blood hs-CRP and hs-cTn levels of treatment group were significantly lower than those in control group.？There was no significantly difference in APACHE Ⅱ score[（21.05±8.58） vs.（18.70±11.21）]and 28 day mortality（25%：15%） between the two groups after treatment.Conclusion;Nicorandil can reduce myocardial damage in patients with ARDS,but can not reduce the patient＇s 28 day mortality.

关 键 词：尼可地尔 急性呼吸窘迫综合征 超敏C反应蛋白 超敏心肌肌钙蛋白 病死率 

分 类 号：R542.2[医药卫生—心血管疾病]