不稳定型心绞痛患者在PCI围术期静脉泵入尼可地尔对再灌注损伤的防治效果观察  

Observation on the preventive effect of intravenous nicorandil on reperfusion injury in patients with unstable angina pectoris during the perioperative period of PCI

作　　者：李倩 LI Qian(Department Two of Circulation,Xingcheng People’s Hospital,Xingcheng 125100,China)

机构地区：[1]辽宁省兴城市人民医院循环二科,125100

出　　处：《中国实用医药》2022年第5期126-129,共4页China Practical Medicine

摘　　要：目的 分析接受经皮冠状动脉介入术(PCI)治疗的不稳定型心绞痛患者在围术期静脉泵入尼可地尔对再灌注损伤的防治效果。方法 100例接受PCI术治疗的不稳定型心绞痛患者,采用随机数字表法分为对照组和试验组,每组50例。对照组患者围术期静脉泵入硝酸甘油治疗,试验组患者围术期静脉泵入尼可地尔治疗。比较两组患者手术前后心肌梗死溶栓实验(TIMI)血流分级情况、术后校正的TIMI帧数(cTFC)、再灌注心肌损伤发生情况。结果 术后,试验组患者TIMI3级占比94.00%高于对照组的78.00%,术后cTFC(17.99±1.77)帧低于对照组的(20.60±1.80)帧,差异具有统计学意义(P<0.05)。试验组患者术后1、2、3 d的肌钙蛋白I(cTnI)水平以及术后再发心绞痛发生率分别为(0.300±0.050)μg/L、(0.200±0.030)μg/L、(0.110±0.020)μg/L、10.00%,均显著低于对照组的(0.540±0.060)μg/L、(0.380±0.050)μg/L、(0.200±0.030)μg/L、32.00%,差异有统计学意义(P<0.05)。结论 不稳定型心绞痛患者在PCI围术期静脉泵入尼可地尔可有效降低心肌受损程度,对再灌注损伤的发生有较高的防治效果,值得在临床推广使用。Objective To analyze the preventive effect of intravenous nicorandil on reperfusion injury in patients with unstable angina pectoris during the perioperative period of percutaneous coronary intervention(PCI).Methods A total of 100 patients with unstable angina pectoris treated by PCI were divided into control group and experimental group by random numerical table,with 50 cases in each group.Patients in the control group were treated with intravenous nitroglycerin during the perioperative period,and patients in the experimental group were treated with intravenous nicorandil during the perioperative period.Both groups were compared in terms of thrombolysis in myocardial infarction(TIMI)flow classification before and after surgery,corrected TIMI frame count(cTFC)and occurrence of reperfusion myocardial injury after surgery.Results After surgery,the proportion of TIMI grade 3 in the experimental group was 94.00%,which was higher than 78.00%in the control group;the cTFC after surgery(17.99±1.77)frames in the experimental group was lower than(20.60±1.80)frames in the control group;all the differences were statistically significant(P<0.05).The levels of cardiac troponin I(cTnI)at 1,2 and 3 d after surgery and recurrence rate of angina pectoris in the experimental group were(0.300±0.050)μg/L,(0.200±0.030)μg/L,(0.110±0.020)μg/L and 10.00%,which were significantly lower than(0.540±0.060)μg/L,(0.380±0.050)μg/L,(0.200±0.030)μg/L,and 32.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion Intravenous nicorandil in patients with unstable angina pectoris during the perioperative period of PCI can effectively reduce the degree of myocardial damage,and has high preventive effect on the occurrence of reperfusion injury,which is worthy of clinical promotion and application.

关 键 词：尼可地尔 不稳定型心绞痛 硝酸甘油 再灌注损伤 经皮冠状动脉介入术 

分 类 号：R541.4[医药卫生—心血管疾病]