经皮冠状动脉介入治疗术中冠脉内注射尼可地尔对改善慢血流的作用分析  

Effect of Intracoronal Injection of Nicodil on Improving Slow Blood Flow during Percutaneous Coronary Intervention

作　　者：苏士奎 SU Shikui(Department of Cardiovascular Medicine,Xinyi People's Hospital,Xinyi,Jiangsu Province,221400 China)

机构地区：[1]新沂市人民医院心血管内科,江苏新沂221400

出　　处：《中外医疗》2023年第35期53-56,共4页China & Foreign Medical Treatment

摘　　要：目的分析经皮冠状动脉介入术中冠脉内注射尼可地尔对慢血流的影响。方法随机选取2020年6月—2023年6月在新沂市人民医院行经皮冠状动脉介入术中收治的慢血流的患者70例为研究对象,根据随机数表法分为两组,注射硝酸甘油的35例纳入对照组;注射尼可地尔的35例纳入观察组;对比两组心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)血流分级、心功能、心肌损伤指标及不良反应发生率。结果观察组TIMI 0~Ⅱ级2例、Ⅲ级33例,对照组TIMI 0~Ⅱ级9例、Ⅲ级26例,差异有统计学意义(Z=2.282,P<0.05)。术后3 d,观察组左心室射血分数较对照组高,左心室收缩末期内径、左心室舒张末期内径较对照组低,差异有统计学意义(P<0.05);观察组肌钙蛋白I、肌酸激酶同工酶、N末端B型利钠肽原为(2.61±0.44)μg/L、(241.56±31.25)U/L、(615.24±53.27)ng/L,较对照组的(3.12±0.61)μg/L、(332.15±42.35)U/L、(731.25±69.58)ng/L低,差异有统计学意义(t=4.012、10.183、7.832,P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论经皮冠状动脉介入术中冠脉内注射尼可地尔可改善慢血流,提升患者心功能,减轻心肌损伤程度,且不会增加不良反应。Objective To analyze the effect of intracoronal injection of nicodil on slow blood flow during percutaneous coronary intervention.Methods 70 patients with slow flow during percutaneous coronary intervention in Xinyi People's Hospital from June 2020 to June 2023 were randomly selected as the study objects and divided into two groups according to the random number table method.35 patients injected with nitroglycerin were included in the control group,and 35 patients injected with nicodil were included in the observation group.Blood flow grading,cardiac function,myocardial injury indexes and the incidence adverse reactions of thrombolysis in myocardial infarction(TIMI)were compared between the two groups.Results Observation group had 2 cases of TIMI 0-Ⅱand 33 cases of TIMIⅢ,control group had 9 cases of 0-Ⅱand 26 cases of TIMIⅢ,the difference was statistically significant(Z=2.282,P<0.05).After 3 d of surgery,the left ventricular ejection fraction of observation group was higher than that of control group,and the left ventricular end-systolic diameter and left ventricular end-diastolic diameter were lower than those of control group,and the differences were statistically significant(P<0.05).The cardiac troponin I,creatine kinase isoenzyme,N-terminal B-type natriuretic peptide in observation group were(2.61±0.44)μg/L,(241.56±31.25)U/L,(615.24±53.27)ng/L,which were lower than those of control group(3.12±0.61)μg/L,(332.15±42.35)U/L,(731.25±69.58)ng/L,and the differences were statistically significant(t=4.012,10.183,7.832,P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Intracoronal injection of nicodil during percutaneous coronary intervention can improve slow blood flow,enhance cardiac function and reduce myocardial injury without increasing adverse reactions.

关 键 词：尼可地尔 经皮冠状动脉介入 冠脉内注射 冠脉慢血流 心肌损伤 

分 类 号：R54[医药卫生—心血管疾病]