替罗非班联合尼可地尔对急诊PCI患者心功能和短期预后的影响

Effect of Nicorandil Combined with Tirofiban on Cardiac Function and Short-Term Prognosis of Patients with Acute Myocardial Infarction undergoing Primary PCI

目的:探讨急诊PCI患者在联合使用替罗非班和尼可地尔后对心功能和短期预后的影响。方法:入选98例接受急诊PCI的AMI患者随机分为对照组(n=49)和联合治疗组(n=49)。对照组单纯给予替罗非班治疗,联合治疗组在对照组基础上给予尼可地尔5 mg tid口服治疗。观察记录两组患者治疗8周前后LVEF、NT-pro BNP水平,并随访MACE事件发生情况。结果:两组患者在治疗前LVEF及NT-pro BNP水平比较没有统计学差异(P>0.05)。在治疗8周后联合治疗组和对照组LVEF及NT-pro BNP水平均较治疗前水平明显改善(P<0.05)。治疗8周后联合治疗组患者LVEF及NT-pro BNP水平明显优于对照组患者(P<0.05)。经过8周的治疗,联合治疗组再次发生心绞痛事件(6.12%VS 24.49%,P=0.025)、恶性心律失常(2.04%VS 16.33%,P=0.036)和心力衰竭事件(2.04%VS 18.37%,P=0.020)明显低于对照组。结论:替罗非班联合尼可地尔可进一步改善急诊PCI患者心功能及短期预后,值得临床推广。

Objective： To investigate the effect of nicorandil combined with tirofiban on cardiac function and short-term prognosis of patients with acute myocardial infarction（AMI） undergoing primary PCI（p PCI）. Methods： A total of 98 AMI patients with p PCI were enrolled and divided into combination therapy group（receiving nicorandil and tirofiban, n=49） and control group（receiving tirofiban only, n=49）. Left ventricular ejection fraction（LVEF）, NT-pro BNP and short-term major adverse cardiovascular events were recorded and analyzed after 8 weeks＇ therapy. Results： There were no statistical significance achieved of LVEF and NT-pro BNP before treatment（P〈0.05）. Compared to that before enrolled, LVEF and NT-pro BNP were improved in both groups after 8 weeks＇ therapy（P〈0.05）. LVEF and NT-pro BNP were improved in combination therapy group, compared to control group after 8 weeks＇ therapy（P〈0.05）.Rates of angina pectoris（6.12% VS 24.49%, P=0.025）, malignant arrhythmia（2.04% VS 16.33%, P=0.036） and heart failure（2.04% VS18.37%, P=0.020） of combination therapy group were lower compared to control groupduring 8 weeks＇ therapy. Conclusion： Nicorandil combined with tirofiban has more pronounced effect for improving cardiac function and short term prognosis of p PCI patients, worth clinical promotion.