尼可地尔的不同给药途径在冠心病经皮冠状动脉介入术后的应用对比分析  

Comparative Analysis of the Application of Different Routes of Administration of Nicorandil in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention

作　　者：王磊 赵云[1] 陈晓瑞[1] WANG Lei;ZHAO Yun;CHEN Xiao-rui(Department of Cardiovascular Medicine,First People's Hospital of Nanyang,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院心血管内科,南阳473000

出　　处：《中国合理用药探索》2023年第1期82-87,共6页Chinese Journal of Rational Drug Use

基　　金：南阳市软科学研究计划项目(RKX085)。

摘　　要：目的:对比尼可地尔不同给药途径对经皮冠状动脉介入(PCI)术后冠心病患者的影响。方法:选取2020年8月~2021年8月期间于本院接受PCI治疗的126例冠心病患者,采用简单随机数字表法分为对照组和观察组,每组63例。对照组在常规治疗基础上静脉注射尼可地尔,观察组在常规治疗基础上经冠状动脉注射尼可地尔。观察两组临床疗效、心功能指标[左室射血分数(LVEF)、6min步行试验(6MWT)及最大摄氧量(VO2max)]、心肌损伤标志物[心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(c TnT)]、血管内皮功能指标[内皮素-1(ET-1)、一氧化氮(NO)]及心血管不良事件发生情况。结果:观察组治疗总有效率(93.65%)高于对照组(79.37%,P<0.05);治疗后,两组LVEF、6MWT及VO2max水平均升高(P<0.05),且观察组各指标水平均高于对照组(P<0.05);两组cTnⅠ、CK-MB、cTnT水平均降低(P<0.05),且观察组各指标水平均低于对照组(P<0.05);两组ET-1水平均降低(P<0.05),且观察组ET-1水平低于对照组(P<0.05);而两组NO水平均升高(P<0.05),且观察组NO水平高于对照组(P<0.05);观察组心血管不良事件发生率(11.11%)低于对照组(25.40%,P<0.05)。结论:冠状动脉内注射尼可地尔可提高PCI术后冠心病患者的临床疗效,改善心功能,减轻心肌损伤,调节血管内皮功能,并降低心血管不良事件的发生。Objective:To compare and analyze the effects of different routes of administration of nicorandil in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods:126patients with coronary heart disease who received PCI in our hospital from August 2020 to August 2021 were selected and assigned into control group and observation group with 63 patients in each group by a simple random number table.The control group was given intravenous nicorandil in combination with conventional treatment,and the observation group was given intracoronary injection nicorandil in combination with conventional treatment.The clinical efficacy,cardiac function index left ventricular ejection fraction(LVEF),six-minute walking test(6MWT)and maximal oxygen uptake(VO2max),myocardial injury marker[cardiac troponinⅠ(cTnⅠ),creatine kinase isoenzymes-MB(CK-MB)and cardiac troponin T(cTnT)],vascular endothelial function index[endothelin-1(ET-1),nitric oxide(NO)]and adverse cardiovascular events were observed in the two groups.Results:The overall response rate in the observation group(93.65%)was higher than that in the control group(79.37%,P<0.05);After treatment,the results of LVEF,6MWT and VO2max all increased in both groups(P<0.05),and the results of each index in the observation group were higher than those in the control group(P<0.05);The levels of cTn I,CK-MB and cTnT decreased in both groups and were lower in the observation group than in the control group(P<0.05);The level of ET-1 decreased(P<0.05)and the level of NO increased in both groups(P<0.05).Compared with the control group,the level of ET-1 in the observation group was lower(P<0.05),while the level of NO was higher(P<0.05);The incidence of adverse cardiovascular events in the observation group(11.11%)was lower than that in the control group(25.40%,P<0.05).Conclusion:Intracoronary injection of nicorandil can improve the efficacy of PCI in patients with coronary heart disease,improve cardiac function,alleviate myocardial injury,regulate vascular endot

关 键 词：尼可地尔 给药途径 冠心病 经皮冠状动脉介入 临床疗效 

分 类 号：R541.4[医药卫生—心血管疾病]