尼可地尔防治缺血性心肌病的临床观察  

Clinical observation of the prevention and treatment of ischemic cardiomyopathy with nicorandil: 40 cases

作　　者：赵红娟[1] 郑云龙[1] 苏丹霞[1] 梁普博[1] ZHAO Hong-juan;ZHENG Yun-long;SU Dan-xia;LIANG Pu-bo(Cardiovascular Department,Guangdong Nongken Central Hospital,Zhanjiang 524002,China)

机构地区：[1]广东省农垦中心医院心血管内科,广东湛江524002

出　　处：《广东医科大学学报》2018年第5期548-551,共4页Journal of Guangdong Medical University

摘　　要：目的观察尼可地尔防治急性非ST段抬高性心肌梗死(NSTEMI)患者发生早期缺血性心肌病(ICM)的价值。方法 80例未行介入治疗的NSTEMI患者随机分为对照组和观察组,两组均予内科常规治疗,观察组还加用尼可地尔片治疗。比较两组住院期间心肌坏死、心绞痛、心律失常发作情况和出院6个月心脏结构和功能。结果两组患者入院第7天肌酸激酶同工酶(CKMB)、肌钙蛋白I(CTnI)、氮末端-脑钠肽前体(NT-ProBNP)、高敏-C反应蛋白(hs-CRP)等指标分别较本组入院24、48 h时改善,且以观察组改善更明显(均P<0.05)。出院6个月,观察组左房舒张末内径(LAEDD)、左室舒张末期内径(LVEDD)、左心射血分数(LVEF)、E/A、NT-ProBNP、6 min步行距离的改善情况均较对照组明显(均P<0.05)。观察组住院期间和出院6个月心绞痛发作次数、持续时间、心律失常发作情况及6个月内因心绞痛或心衰发作再住院率均少于对照组(均P<0.05);而不良反应并无明显增加(P>0.05)。结论尼可地尔片不仅可改善NSTEMI患者近期心绞痛、心律失常和心肌坏死等指标,还可改善此类患者的心肌结构及远期疗效,对ICM早期防治起到一定作用。Objective To explore the value of nicoradil in the early prevention and treatment of ischemic cardiomyopathy(ICM)in patients with acute non-ST-elevation myocardial infarction(NSTEMI).Methods Eighty NSTEMI patients without interventional therapy were randomly divided into Control Group and Observation Group.Both groups received routine medical treatment while the Observation Group was additionally administered with nicorandil tablets.The attack of myocardial necrosis,angina and arrhythmia as well as the cardiac structure and function at 6 months after discharge were compared between the two groups.Results On the 7th day after admission,both groups had improvement in the creatine kinase isoenzyme(CKMB),cardiac troponin I(CTnI),N-terminal pro brain natriuretic peptide(NT-ProBNP)and highsensitivity C-reactive protein(hs-CRP)compared with those at the 24h and 48h after admission,and the Observation Group had more significant improvement(P<0.05 for all).6 months after discharge,the Observation Group had the improvement in the left atrium diastolicdiameter(LAEDD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),E/A,NT-ProBNP and 6-minute walking distance more significant than the Control Group(P<0.05 for all).The Observation Group had the incidence and duration of angina,attack of arrhythmia,and the rehospitalization rate within 6 months due to angina and arrhythmia less than the Control Group(P<0.05 for all);however,there was no significant increase in the adverse reactions(P>0.05).Conclusion Nicoradil tablets can not only improve the near-term indicators of angina,arrhythmia and myocardial necrosis in patients with NSTEMI,but also improve the cardiac structure and long-term efficacy of such patients.It may play a certain role in the early prevention and treatment of ICM.

关 键 词：尼可地尔 缺血性心肌病 急性非ST段抬高性心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]