尼可地尔对急性心肌梗死患者短期预后的影响

The Influence of Short-term Prognosis by Nicoradil Treatment on Patients with Acute Myocardial Infarction(AMI)

目的:研究缺血预处理对ST抬高的急性心肌梗死患者短期预后的影响。方法:采用随机、临床对照实验方法。选择确诊为ST抬高的急性心肌梗死患者90例作为研究对象。随机分为3组,即尼可地尔(钾通道开放剂)低剂量治疗组、尼可地尔高剂量治疗组以及对照组,每组各30例,3组患者均接受ST抬高的急性心肌梗死标准治疗,其中尼可地尔治疗组在标准方案基础上加用尼可地尔。研究主要终点为治疗后CK、CKMB、LDH的峰值活性和EF值,研究次要终点为住院期间泵衰竭的发生率、恶性心律失常的发生率以及各组缺血区室壁运动。结果:2组尼可地尔治疗组分别与对照组两两比较均有较低的酶峰值活性,较高的EF值,住院期间泵衰竭、恶性心律失常的发生概率均较低,而缺血区室壁运动障碍较小(均P<0.05)。而尼可地尔高低剂量组各指标之间均无显著性差异(P>0.05)。结论:尼可地尔可改善急性心肌梗死患者的短期预后,而尼可地尔增加服用剂量有益性并不增加。

Objective：To study the influence of short-term prognosis on AMI patients with ischemin treatment. Methods：Take the method of radom and clinical control experiment. Ninety patients of chest pain were diagnosed ST-elevation AMI, divided into three groups according to whether or not oral nicoradil therapy and dosage, including low-dosage, high-dosage therapy group and control group. Each group is 30 cases. All patients were treated the normal therapy of ST-elevation AMI. The two nicoradil therapy group not only take the normal therapy , but also nicoradil. The primary end point of the study ws to measure the quantity of creatine kinase, MB creatine kinase , L-lactate dehydrogenase and eject fraction of left ventricular after therapy.The secondary end point was incidence of left heart failure and malignant ventrieular arrhymia, ventricular movement of ischemic area in hospitalization. Results：The peak value of CK, CKMB, LDH and incidence of left heart failure, malignant ventricular arrhythmia and the ventrieular movement ahnormity in the group of oral nicorandil therapy were lower than contral group. And the EF value were higher than control group, P〈0.05. All the numerical value of two therapy group have not significance difference, P〈0.05. Conclusion：Nicoradil can improve the short-term prognosis of the patients with AMI. Incremental dosage of nicoradil does not improve short-term prognosis.