尼可地尔对行急诊冠状动脉介入治疗的急性ST段抬高型心肌梗死患者心功能、肾功能的影响  

Effect of Nicodil on Cardiac Function and Renal Function in Patients with Acute ST Segment Elevation Myocardial Infarction Undergoing Emergency Percutaneous Coronary Intervention

作　　者：张大伟 陈蓉 ZHANG Dawei;CHEN Rong(Department of Cardiology,Zhenjiang First People's Hospital,Zhenjiang Jiangsu 212002)

机构地区：[1]镇江市第一人民医院心内科,江苏镇江212002

出　　处：《医学临床研究》2025年第1期64-67,共4页Journal of Clinical Research

摘　　要：【目的】探讨尼可地尔对行急诊经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI)患者心功能和肾功能的影响。【方法】回顾性分析2020年11月至2022年8月在本院行急诊PCI术治疗的160例急性STEMI患者的临床资料,根据治疗方法不同将其分为观察组(常规治疗+尼可地尔,n=89)和对照组(常规治疗,n=71)。比较两组ST段回落情况、超声心动图参数[左室射血分数(LVEF)、左室舒张末期内径(LVDD)、左室收缩末期内径(LVDS)]及肾功能指标(血肌酐、尿素氮、尿酸)。【结果】对照组患者PCI术后2 h的ST段回落率≥50%所占比例低于观察组,差异有统计学意义(P<0.05)。术后1周、术后1个月,两组LVDD、LVEF均高于术后1 d,差异有统计学意义(P<0.05),两组LVDS与术后1 d比较,差异无统计学意义(P>0.05)。观察组术后1周、术后1个月LVDD、LVEF、LVDS比较,差异无统计学意义(P>0.05)。观察组术后2 d尿素氮水平低于术前,差异有统计学意义(P<0.05),血肌酐、尿酸水平与术前比较,差异无统计学意义(P>0.05);对照组术后2 d尿素氮、血肌酐及尿酸水平与术前比较,差异无统计学意义(P>0.05);观察组术后2 d尿素氮、血肌酐及尿酸水平均低于对照组,差异有统计学意义(P<0.05)。观察组中前壁梗死患者尿素氮、血肌酐及尿酸水平与术前比较,差异无统计学意义(P>0.05);下壁梗死患者术后2 d尿素氮、尿酸水平低于术前,差异有统计学意义(P<0.05)。对照组中前壁梗死患者术后2 d血肌酐、尿酸水平高于术前,差异有统计学意义(P<0.05);下壁梗死患者术后2 d尿素氮水平低于术前,差异有统计学意义(P<0.05)。【结论】尼可地尔可改善行急诊PCI术的急性STEMI患者心肌灌注水平,保护肾脏功能,尤其对前壁梗死患者的肾脏保护作用可能更明显。【Objective】To investigate the effects of nicodil on cardiac function and renal function in patients with acute ST elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).【Methods】The clinical data of 160 patients with acute STEMI who underwent emergency PCI in Zhenjiang First People's Hospital from November 2020 to August 2022 were retrospectively analyzed,and they were divided into observation group(conventional treatment+nicodil,n=89)and control group(conventional treatment,n=71)according to treatment methods.ST segment regression,echocardiographic parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVDD),left ventricular end-systolic diameter(LVDS)]and renal function indicators(serum creatinine,urea nitrogen,uric acid)were compared between the two groups.【Results】The proportion of ST segment regression rate≥50%in the control group 2 h after PCI was lower than that in the observation group,and the difference was statistically significant(P<0.05).At 1 week and 1 month after surgery,LVDD and LVEF in 2 groups were higher than 1 day after surgery,the difference was statistically significant(P<0.05),while LVDS in 2 groups was not statistically significant compared with 1 day after surgery(P>0.05).There was no significant difference in LVDD,LVEF and LVDS between the observation group at 1 week and 1 month after surgery(P>0.05).The level of urea nitrogen 2 days after operation was lower than that before operation,the difference was statistically significant(P<0.05),but there was no statistically significant difference in serum creatinine and uric acid levels between the observation group and before operation(P>0.05).There were no significant differences in the levels of urea nitrogen,creatinine and uric acid in patients with anterior infarction in the observation group(P>0.05).The levels of urea nitrogen and uric acid 2 days after operation in patients with inferior infarction were lower than those before operation,and the diff

关 键 词：ST段抬高型心肌梗死 急性病 尼可地尔 心脏功能试验 肾功能试验 

分 类 号：R542.22[医药卫生—心血管疾病]