尼可地尔对行择期经皮冠状动脉介入治疗的急性非ST段抬高心肌梗死患者心功能及运动耐量的影响

Effect of nicorandil on cardiac function and exercise tolerance in patients with non-ST-elevation myocardial infarction after elective percutaneous coronary intervention

目的探讨尼可地尔对择期经皮冠状动脉介入治疗(PCI)术后急性非ST段抬高心肌梗死(NSTEMI)患者心功能及运动耐量的影响。方法 80例NSTEMI患者随机分成对照组、尼可地尔组,每组40例,对两组患者心功能及运动耐量进行6个月随访观察和比较。主要观察指标包括:左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、6分钟步行距离(6MWD)、美国纽约心脏病协会分级(NYHA分级)以及主要心血管不良事件(MACE)。结果两组基线心功能指标比较差异均无统计学意义(P>0.05),随访6个月时,尼可地尔组LVEF较前升高、LVEDD明显缩小、NYHA分级较前改善(P<0.05);对照组LVEF、NYHA分级均较前改善(P<0.05),但LVEDD较前扩大(P<0.05)。随访6个月时,尼可地尔组LVEF、LVEDD、6MWD、NYHA分级与对照组比较差异均有统计学意义(P<0.01);随访6个月尼可地尔组MACEs发生率明显低于对照组(10.0%vs 26.7%,P<0.05)。结论尼可地尔能够改善择期PCI术后NSTEMI患者的心功能,提高了患者的运动耐量,降低MACE发生率。

Objective To investigate the effect of nicorandil on cardiac function and exercise tolerance in patients with non-ST-elevation myocardial infarction（NSTEMI）after elective percutaneous coronary intervention（PCI）.Methods Totally 80 patients with NSTEMI were randomly assigned to two groups：control group and nicorandil group,40 cases in each group.The left ventricular ejection fraction（LVEF）,left ventricular end-diastolic diameter（LVEDD）,6 min walking distance（6MWD）,New York Heart Association classification（NYHA classification）of heart function and major adversecardiac events（MACEs）were calculated.Patients were followed up for six months.Results There were no significant difference in baseline evaluation indexes of heart function characteristics between two groups（P〈0.05）.After six months,LVEF was significantly increased,LVEDD decreased significantly,NYHA classification was significantly improved in nicorandil group（P〈0.05）.In control group,LVEF and NYHA classification were significantly improved（P〈0.05）,but LVEDD was significantly increased as compared with baseline（P〈0.05）.Patients were followed up for six months.The LVEF,LVEDD,6MWD and NYHA classification of two groups were statistically significant（P〈0.05）,and the occurrence of MACEs in nicorandil group was significantly lower than that in control group（10.0% vs 26.7%,P〈0.05）.Conclusion Nicorandil can improve heart function,increase exercise capacity and reduce the incidence of MACE in patients with NSTEMI after elective PCI.