尼可地尔辅助替罗非班治疗急性STEMIPCI术后患者的疗效观察  

Effect of nicorandil assisted tirofiban in the treatment of acute STEMI patients undergoing PCI

作　　者：张世威 沈志方[2] 常国栋[2] Zhang Shi-wei;Shen Zhi-fang;Chang Guo-dong(Department of Cardiology,The People's Hospital of Yucheng,Shangqiu 476300,Henan,China;Department of Cardiology,Shangqiu First People's Hospital,Shangqiu 476300,Henan,China)

机构地区：[1]虞城县人民医院心血管内科,河南商丘476300 [2]商丘市第一人民医院心血管内科,河南商丘476300

出　　处：《四川生理科学杂志》2023年第7期1205-1208,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨尼可地尔辅助替罗非班治疗行经皮冠状动脉介入术(Percutaneous coronary intervention,PCI)的急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者的疗效。方法:收集2019年10月至2021年10月我院收治的急性STEMI患者84例,两组均行PCI治疗,随机分为替罗非班组(n=42)和尼可地尔辅助组(n=42)。替罗非班组接受替罗非班治疗,尼可地尔辅助组在替罗非班组基础上给予尼可地尔辅助治疗。治疗1 m后,比较两组心功能指标、凝血功能指标、心肌梗死溶栓试验血流分级、氧化应激相关指标、心血管不良事件(Major adverse cardiovascular events,MACE)发生率。结果:治疗后,尼可地尔辅助左心室舒张末期的内径、左心室收缩末期的内径、血清纤维蛋白原、丙二醛水平低于替罗非班组,左心室的射血分数、凝血酶时间、活化部分凝血酶时间、凝血酶原时间、超氧化物歧化酶、还原型谷胱甘肽水平高于替罗非班组,血流分级情况优于替罗非班组(P<0.05);尼可地尔辅助组MACE发生率(7.14%)低于替罗非班组(23.81%)(P<0.05)。结论:尼可地尔辅助替罗非班治疗行PCI术的急性STEMI患者可有效改善患者心功能和凝血功能,有效缓解机体的氧化应激状态,减少MACE的发生,有利于患者PCI术后的康复和预后。Objective:To investigate the effect of nicorandil assisted tirofiban in the treatment of acute ST segment elevation myocardial infarction(STEMI)patients undergoing percutaneous coronary intervention(PCI).Methods:84 patients with acute STEMI admitted to our hospital from October 2019 to October 2021 were collected and divided into tirofiban group(n=42)and nicorandil assisted group(n=42)according to different treatment schemes.Both groups received PCI,Tirofiban group received tirofiban,and nicorandil assisted group received nicorandil assisted treatment on the basis of tirofiban group.After 1 month of treatment,the cardiac function indexes,thrombolysis in myocardial infarction(TIMI)blood flow classification,oxidative stress related indicators,and the incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results:After treatment,the levels of left ventricular end diastolic dimension,left ventricular end systolic diameter,serum fibrinogen and malondialdehyde in nicorandil assisted group were lower than those in tirofiban group,while the left ventricular ejection fraction,thrombin time,activated partial thromboplastin time,prothrombin time,superoxide dismutase and reduced glutathione were higher than those in tirofiban group.TIMI blood flow classification was better than that in tirofiban group(P<0.05);the incidence of MACE in nicorandil assisted group(7.14%)was lower than that in tirofiban group(23.81%)(P<0.05).Conclusion:Nicorandil assisted tirofiban in the treatment of acute STEMI patients undergoing PCI can effectively improve their cardiac function and blood coagulation function,effectively alleviate the oxidative stress state of the body,reduce the occurrence of MACE,and is conducive to the rehabilitation and prognosis of patients after PCI.

关 键 词：尼可地尔 替罗非班 经皮冠状动脉介入术 急性心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]