冠脉内注射尼可地尔对急性心肌梗死PCI术中慢血流/无复流患者的效果  

Effects of injecting nicorandil into intracoronary on acute coronary syndrome patients with coronary slow flow and no reflow phenomenon during percutaneous coronary intervention

作　　者：颜青松 刘选姣 吕春美 邹海林 彭子敬 贺文慨 YAN Qingsong;LIU Xuanjiao;L Chunmei;ZOU Hailin;PENG Zijing;HE Wenkai(Department of Cardiology,The First Affiliated Hospital of Shaoyang University,Shaoyang 422000,China)

机构地区：[1]邵阳学院附属第一医院心血管内科,湖南邵阳422000

出　　处：《邵阳学院学报（自然科学版）》2023年第5期1-6,共6页Journal of Shaoyang University：Natural Science Edition

基　　金：湖南省教育厅资助项目(19C1651)。

摘　　要：目的 探讨冠脉内注射尼可地尔治疗急性心肌梗死(acute myocardial infarction, AMI)行经皮冠脉介入术(pneumatosis cystoides intestinalis, PCI)中出现慢血流(coronary slow flow, CSF)/无复流(no reflow, NR)的有效性、预后及远期影响。方法 选取2020年7月至2022年4月邵阳学院附属第一医院收治诊断为AMI且符合入选标准的121例患者,随机分为2组,试验组(n=60)冠脉内注射尼可地尔2 mg+术后长期口服5 mg 3次/d,对照组(n=61)仅术中冠脉内注入1次硝普钠200μg。比较2组患者术后左室射血分数(left ventricular ejection fraction, LVEF)、主要不良心血管事件(major adverse cardiovascular events, MACE)、再入院与死亡情况等。结果 试验组术后30 d、3个月、6个月的LVEF值均高于对照组(均P<0.05);术后30 d的MACE、术后6个月内再入院率均低于对照组(均P<0.05)。结论 尼可地尔可有效改善AMI患者急诊PCI术中PCI/NR现象,坚持术后长期口服对患者的远期预后有积极作用。Objective To investigate the efficacy,prognosis and long-term effects of intra coronary injection of nicodil in the treatment of acute myocardial infarction(AMI)with slow flow or no reflow during percutaneous coronary intervention.Methods A total of 121 patients who were diagnosed acute myocardial infarction and suit to the inclusion criteria were admitted to the First Affiliated Hospital of Shaoyang University from July 2020 to April 2022.The patients were randomly assigned in an experimental group(n=60 the patients were injected 2 mg nicodil intracoronary and 5 mg nicodil orally 3 times a day for a long period post-operation),and a control group(n=61 the patients were only injected nitroprusside 200μg into the coronary artery once during operation).Left ventricular ejection fraction(LVEF),major adverse cardiovascular events(MACE),readmission rate,and mortality were compared between the 2 groups.Results The LVEF value of experimental group was higher than that of the control group at 30 d,3 months,and 6 months post-operation(P<0.05);MACE at 30 days and readmission rate at 6 months post-operation were lower than those in the control group(P<0.05).Conclusion Nicodil can improve slow blood flow or no reflow in AMI patients effectively which undergoing acute percutaneous coronary intervention.Persisting in long-term oral administration has a positive effect on the long-term prognosis of patients.

关 键 词：尼可地尔 急性心肌梗死 经皮冠脉介入术 慢血流/无复流 

分 类 号：R542.22[医药卫生—心血管疾病]