尼可地尔联合替格瑞洛对冠心病患者PCI术后心功能及血清cTnI、NT-proBNP水平的影响  

Effects of Nicorandil Combined with Ticagrelor on Cardiac Function,Serum cTnI and NT-proBNP Levels in Patients with Coronary Heart Disease after PCI

作　　者：李靓 翟清[2] 杨洋 吴秋香 LI Liang;ZHAI Qing;YANG Yang;WU Qiuxiang(Department of Cardiology,Wuhu Second People′s Hospital,Wuhu 241000,China;Department of Endocrinology,Yijishan Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]芜湖市第二人民医院心内科,安徽芜湖241000 [2]皖南医学院弋矶山医院内分泌科,安徽芜湖241001

出　　处：《医学综述》2021年第15期3084-3089,共6页Medical Recapitulate

基　　金：皖南医学院重点科研项目培育基金项目(WK2017ZF09)。

摘　　要：目的探讨尼可地尔联合替格瑞洛对冠心病患者经皮冠状动脉介入治疗(PCI)术后心功能及血清心肌肌钙蛋白I(cTnI)、N端脑钠肽前体(NT-proBNP)水平的影响。方法选取2019年1月至2020年9月于芜湖市第二人民医院接受PCI治疗的83例冠心病患者作为研究对象,按照治疗方法不同分为替格瑞洛组(43例)和联合组(40例)。其中,替格瑞洛组给予替格瑞洛治疗,联合组给予尼可地尔联合替格瑞洛治疗。比较两组患者治疗前后的心功能指标[短轴缩短率(FS)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]、血清心肌损伤标志物[肌酸激酶(CK)、cTnI、乳酸脱氢酶(LDH)]、凝血功能相关指标[纤维蛋白原(FIB)、凝血酶原时间(PT)]、NT-proBNP及主要不良心血管事件(MACE)发生情况。结果FS的组间与时点间存在交互作用(P<0.05),LVEF、LVEDD的组间与时点间不存在交互作用(P>0.05),治疗后两组患者的FS、LVEF均升高,且联合组高于替格瑞洛组;LVEDD降低,且联合组低于替格瑞洛组(P<0.05)。CK、LDH的组间与时点间存在交互作用(P<0.01),cTnI的组间与时点间不存在交互作用(P>0.05),治疗后两组患者的CK、cTnI、LDH水平均降低,且联合组低于替格瑞洛组(P<0.05)。FIB、PT的组间与时点间存在交互作用(P<0.05),NT-proBNP的组间与时点间不存在交互作用(P>0.05),治疗后两组患者的FIB、NT-proBNP水平均降低,且联合组低于替格瑞洛组;PT延长,且联合组长于替格瑞洛组(P<0.05)。联合组总MACE发生率低于替格瑞洛组[10.00%(4/40)比27.91%(12/43)](P<0.05)。结论尼可地尔联合替格瑞洛治疗可明显改善冠心病患者PCI术后心功能,增强心肌功能,改善凝血功能,降低MACE发生率。Objective To explore the effects of nicorandil combined with ticagrelor on cardiac function,serum cardiac troponin I(cTnI)and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 83 patients with coronary heart disease undergoing PCI in Wuhu Second People′s Hospital between Jan.2019 and Sep.2020 were enrolled as the research objects.According to different treatment methods,they were divided into a ticagrelor group(43 cases)and a combination group(40 cases).The ticagrelor group was treated with ticagrelor,and the combination group was treated with nicorandil combined with ticagrelor.The cardiac function indexes[fractional shortening(FS),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)],levels of serum myocardial injury markers[creatine kinase(CK),cTnI,lactate dehydrogenase(LDH)],coagulation function related indexes[fibrinogen(FIB),prothrombin time(PT)],NT-proBNP level and occurrence of major adverse cardiovascular events(MACE)before and after treatment were compared between the two groups.Results There were interaction effects between groups and time points in terms of FS(P<0.05),while there was no interaction effect in terms of LVEF or LVEDD(P>0.05).After treatment,FS and LVEF in both groups were increased,which were higher in the combination group than the ticagrelor group;and LVEDD in both groups was decreased,which was lower in the combination group than the ticagrelor group(P<0.05).There were interaction effects between groups and time points in terms of CK and LDH(P<0.01),while there was no interaction effect in terms of cTnI(P>0.05).After treatment,levels of CK,cTnI and LDH in both groups were decreased,which were lower in the combination group than the ticagrelor group(P<0.05).There were interaction effects between groups and time points in terms of FIB and PT(P<0.05),while there was no interaction effect in terms of NT-proBNP(P>0.05).After treatment,levels

关 键 词：冠心病 经皮冠状动脉介入治疗 尼可地尔 替格瑞洛 心功能 N端脑钠肽前体 心肌肌钙蛋白I 

分 类 号：R541.4[医药卫生—心血管疾病]