注射用尼可地尔对急性心肌梗死心律失常事件的影响探究  

Exploration of the effect of Nicorandil injection on arrhythmic events in acute myocardial infarction

作　　者：高振 徐增政 吴培堂 Gao Zhen;Xu Zengzheng;Wu Peitang(Shanxian central hospital,Heze,Shandong 274300,China)

机构地区：[1]山东省单县中心医院,山东菏泽274300

出　　处：《首都食品与医药》2023年第22期66-69,共4页Capital Food Medicine

摘　　要：目的探讨注射用尼可地尔对急性心肌梗死心律失常的治疗效果。方法选取山东省单县中心医院2022年6月-2023年3月收治的100例急性心肌梗死患者为研究对象,按照患者自愿选择的治疗方案,将患者分成经皮冠状动脉介入治疗(PCI)组(n=50)和保守治疗组(n=50);依据随机对照的原则将两组患者又分为两个亚组,分别为研究组(n=25)、对照组(n=25),其中研究组均采用标准治疗+注射用尼可地尔治疗;对照组单纯采用标准治疗方案,不使用尼可地尔治疗。比较患者心电图QT离散度(QTd)、心律失常情况、心脏超声检查结果、实验室生化指标。结果治疗前PCI组、保守治疗组QTd对比差异无统计学意义(P>0.05);治疗后PCI组、保守治疗组中研究组QTd水平低于对照组(P<0.05)。治疗后PCI组中研究组心率失常发生率、持续时间指标均低于对照组(P<0.05)。治疗前PCI组、保守治疗组中两组左室射血分数(LVEF)、左心室收缩末期容积指数(LVESVI)对比,差异无统计学意义(P>0.05);治疗后PCI组、保守治疗组中研究组LVEF低于对照组,LVESVI低于对照组(P<0.05)。治疗前PCI组、保守治疗组N末端B型脑钠肽前体(NT-ProBNP)、肌酸激酶同工酶(CKMB)、心肌肌钙蛋白I(cTnI)对比,差异无统计学意义(P>0.05);治疗后PCI组、保守治疗组中研究组NT-ProBNP、CKMB、cTnI均低于对照组(P<0.05)。结论注射用尼可地尔在急性心肌梗死患者的治疗中发挥理想作用,无论是PCI术还是保守治疗方案,加入尼可地尔均可显著提升治疗疗效,降低QTd,减少心律失常的发生,使患者的心功能指标得到逆转,并且可促进血清生化指标的改善。Objective To explore the therapeutic effect of injectable Nicorandil on arrhythmia in acute myocardial infarction.Methods 100 patients with acute myocardial infarction admitted to our hospital from June 2022 to March 2023 were selected as the study subjects.According to the treatment scheme voluntarily selected by the patients,the patients were divided into Percutaneous coronary intervention(PCI)group(n=50)and Conservative management group(n=50);according to the principle of randomized control,the two groups of patients were divided into two subgroups,namely the study group(n=25)and the control group(n=25).The study group was treated with standard treatment and injection of Nicorandil;the control group received a simple standard treatment plan and did not receive treatment with Nicorandil.Compare patients'electrocardiogram QT dispersion(QTd),arrhythmia status,cardiac ultrasound examination results,and laboratory biochemical indicators.Results There was no significant difference in QTd between PCI group and Conservative management group before treatment(P>0.05);after treatment,the QTd level in PCI group and Conservative management group was lower than that in control group(P<0.05).After treatment,the incidence and duration of arrhythmia in the PCI group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference in left ventricular Ejection fraction(LVEF)and left ventricular end systolic volume index(LVESVI)between the PCI group and the Conservative management group(P>0.05);after treatment,LVEF in the study group was lower than that in the control group,and LVESVI in the PCI group and the Conservative management group was lower than that in the control group(P<0.05).Before treatment,there was no significant difference between the PCI group and the Conservative management group in the comparison of N-terminal B-type pro brain natriuretic peptide(NT-ProBNP),Creatine kinase Isozyme(CK-MB),and myocardial Troponin I(cTnI)(P>0.05);after treatment,NT-ProBNP,CK-MB,cTnI in the st

关 键 词：尼可地尔 急性心肌梗死 心律失常 超声心功能 心肌损伤 

分 类 号：R541[医药卫生—心血管疾病]