预防性冠状动脉内注射瑞替普酶、尼可地尔对STEMI患者PCI术后冠状动脉血流的影响分析  

Influence of prophylactic intra-coronary injection of reteplase and nicorandil on coronary blood flow in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention

作　　者：梁鹏 周泓宇 黎百志 何小姣 Liang Peng;Zhou Hongyu;Li Baizhi;He Xiaojiao(Department of Cardiovascular Medicine,People's Hospital of Dazu District,Chongqing 402360,China;不详)

机构地区：[1]重庆市大足区人民医院心血管内科,重庆402360

出　　处：《中国循证心血管医学杂志》2024年第12期1479-1482,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：重庆市大足区科技发展项目(DZKJ2022JSYJ-KWXM1047)。

摘　　要：目的分析预防性冠状动脉内注射瑞替普酶、尼可地尔对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后冠状动脉血流的影响。方法选择2021年1月至2023年1月于重庆市大足区人民医院就诊的136例STEMI患者,根据治疗方法不同分为:对照组69例采用预防性冠状动脉内注射硝酸甘油,观察组67例采用预防性冠状动脉内注射瑞替普酶、尼可地尔。比较两组患者心肌梗死溶栓治疗(TIMI)血流分级、心功能参数、血清炎性因子、不良心血管事件总发生率。结果治疗后观察组TIMI血流分级2级、3级均高于对照组(47.76%vs.42.03%;31.34%vs.14.49%),差异有统计学意义(P<0.05)。观察组左室射血分数(LVEF)高于对照组,左室舒张末期内径(LVEDD)、血清心肌肌钙蛋白Ⅰ(cTnI)、肌酸激酶同工酶(CK-MB)均低于对照组(P<0.05)。观察组治疗后血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)均低于对照组(P<0.05)。观察组不良心血管事件总发生率低于对照组(1.49%vs.11.59%,P<0.05)。结论STEMI患者预防性冠状动脉内注射瑞替普酶、尼可地尔有效改善PCI术后TIMI血流分级和心功能,减轻炎症反应,预防心血管不良事件发生。Objective To analyze the influence of prophylactic intra-coronary injection of reteplase and nicorandil on coronary blood flow in patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods STEMI patients(n=136)were chosen from People's Hospital of Dazu District of Chongqing City from Jan.2021 to Jan.2023.The patients were divided,according different therapies,into control group(n=69)treated with prophylactic intra-coronary injection of nitroglycerin,and observation group(n=67)treated with prophylactic intra-coronary injection of reteplase and nicorandil.The indexes of flow grades of thrombolysis in myocardial infarction(TIMI),heart function,serum inflammatory factors and total incidence of major adverse cardiovascular events(MACE)were compared between 2 groups.Results After treatment,the percentages of grades 2 and 3 of TIMI flow grades were higher(47.76%vs.42.03%;31.34%vs.14.49%,P<0.05),left ventricular ejection fraction(LVEF)was higher,and left ventricular end-diastolic diameter(LVEDD),cardiac troponin I(cTnI)and creatine kinase-MB isoenzyme(CK-MB)were lower(P<0.05)in observation group than those in control group.The levels of interleukin-6(IL-6)and high sensitivity C-reactive protein(hs-CRP)were lower in observation group than those in control group(P<0.05).The total incidence of MACE was lower in observation group than that in control group(1.49%vs.11.59%,P<0.05).Conclusion The prophylactic intra-coronary injection of reteplase and nicorandil can effectively improve TIMI flow grades and heart function,relieve inflammatory response and prevent MACE occurrence in STEMI patients.

关 键 词：急性ST段抬高型心肌梗死 经皮冠状动脉介入治疗 瑞替普酶 尼可地尔 

分 类 号：R542.22[医药卫生—心血管疾病]