术前应用尼可地尔对冠心病择期PCI治疗患者的心肌损伤、心脏血流灌注及室壁运动的影响  

Effect of preoperative nicordil on myocardial protection of patients with coronary heart disease treated with elective PCI and its effect on cardiac blood perfusion and ventricular wall movement

作　　者：刘魁智 朱自强[1] LIU Kuizhi;ZHU Ziqiang(Zhengzhou Seventh People′s Hospital,Zhengzhou 450016,Henan,P.R.China)

机构地区：[1]郑州市第七人民医院,河南郑州450016

出　　处：《滨州医学院学报》2022年第6期437-439,471,共4页Journal of Binzhou Medical University

摘　　要：目的研究术前应用尼可地尔对冠心病择期经皮冠状动脉介入(PCI)治疗患者的心肌损伤、心脏血流灌注及室壁运动的影响。方法选取107例冠心病择期PCI治疗患者随机分组,对照组53例术前给予常规治疗,观察组54例在对照组基础上联合应用尼可地尔,比较两组患者心肌损伤、心脏血流灌注、室壁运动及左心功能和主要不良心血管事件(MACE)的差异。结果观察组术后心肌肌钙蛋白I(cTnI)、磷酸肌酸激酶水平(CK-MB)水平和cTnI超过5倍患者数量均低于对照组(P<0.05或<0.01)。观察组术后校正的TIMI帧数(CTFC)水平和术后心肌梗死溶栓试验(TIMI)血流分级0~2级患者数量低于对照组,术后TIMI3级患者数量高于对照组(P<0.05或<0.01)。观察组术后左心室室壁运动评分指数(WMSI)低于对照组,左室射血分数(LVEF)水平高于对照组(P<0.05)。两组患者再发心力衰竭、梗死后心绞痛、再发心肌梗死等的发生率比较,差异无统计学意义。结论术前应用尼可地尔对冠心病择期PCI治疗患者效果确切,能够有效地减轻患者心肌损伤程度,改善心脏血流灌注、室壁运动及左心功能,安全性高,具有临床推广价值。Objective To investigate the effects of nicorandil on myocardial injury,cardiac blood perfusion and ventricular wall movement in patients with coronary heart disease undergoing elective percutaneous coronary intervention(PCI).Methods Totally 107 patients with coronary heart disease undergoing elective PCI were randomly divided into the control group(53 cases)and the observation group(54 cases)with the conventional treatment and nicorandil on the basis of the control group.Myocardial injury,cardiac blood perfusion,wall motion,left heart function and Major Adverse Cardiovascular Events(MACE)were compared between the two groups.Results The levels of cardiac troponin I(cTnI),creatine kina-MB(CK-MB)and the number of patients with cTnI more than 5 times after the operation in the observation group were lower than those in the control group(P<0.05 or<0.01).Corrected TIMI Frame Count(CTFC)level and the number of patients with postoperative thrombolysis in myocardial infarction(TIMI)blood flow grade 0~2 in the observation group were lower than those in the control group,and the number of patients with postoperative TIMI grade 3 was higher than that in the control group(P<0.05 or<0.01).The Left Ventricular Wall motion score index(WMSI)in the observation group was lower than that in the control group,and the Left Ventricular ejection fraction(LVEF)was higher than that in the control group(P<0.05).There was no significant difference in the incidence of recurrent heart failure,post-infarction angina pectoris and recurrent myocardial infarction between the two groups.Conclusion Preoperative application of Nicordil has definite effect on patients with coronary heart disease treated by selective PCI,can effectively reduce the degree of myocardial injury in patients,improve cardiac blood perfusion,ventricular wall movement and left heart function,with high safety and clinical promotion value.

关 键 词：尼可地尔 心肌损伤 冠心病 室壁运动 

分 类 号：R541.4[医药卫生—心血管疾病]