二丁酰环磷腺苷钙联合尼可地尔治疗急性ST段抬高型心肌梗死的临床研究

Clinical study of calcii dibutyry-ladenosini cyclophosphas combined with nicorandil in treatment of acute ST segment elevation myocardial infarction

目的探究二丁酰环磷腺苷钙联合尼可地尔治疗急性ST段抬高型心肌梗死的临床疗效。方法选取2016年7月—2017年7月开封市第二人民医院心内科及门诊收治的急性ST段抬高型心肌梗死患者132例,随机分为对照组和治疗组,每组各66例。对照组患者口服尼可地尔片,1片/次,3次/d。治疗组在对照组治疗基础上肌内注射注射用二丁酰环磷腺苷钙,20 mg/次,2次/d。两组患者均连续用药2周。观察两组的临床疗效,比较两组治疗前后左心室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左心室收缩末期内径(LVESD)、心肌肌钙蛋白Ⅰ(cTnⅠ)、B型脑钠肽(BNP)水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别为83.33%、95.45%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的LVEDD、LVESD、cTnⅠ、BNP、心肌梗死面积均显著降低,LVEF水平均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,LVEDD、LVESD、cTnⅠ、BNP、心肌梗死面积显著低于对照组,LVEF水平高于对照组,两组比较差异具有统计学意义(P<0.05)。结论二丁酰环磷腺苷钙联合尼可地尔治疗急性ST段抬高型心肌梗死具有较好的临床疗效,可显著改善患者心功能指标,改善心肌损伤水平,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of calcii dibutyry-ladenosini cyclophosphas combined with nicorandil in treatment of acute ST segment elevation myocardial infarction. Methods Patients（132 cases） with acute ST segment elevation myocardial infarction in Kaifeng Second People＇s Hospital from July 2016 to July 2017 were randomly divided into control（66 cases） and treatment（66 cases） groups. Patients in the control group were po administered with Nicorandil Tablets, 1 tablet/time, three times daily. Patients in the treatment group were im administered with Calcii Dibutyry-ladenosini Cyclophosphas for injection on the basis of the control group, 20 mg/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of LVEDD, LVEF, LVESD, cTnⅠ, and BNP in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 83.33% and 95.45%, and there were differences between two groups（P〈0.05）. After treatment, LVEDD, LVESD, cTnⅠ, BNP and myocardial infarction area were significantly decreased in two groups, but LVEF was significantly increased, and there were differences in the same group（P〈0.05）. After treatment, LVEDD, LVESD, cTnⅠ, BNP and myocardial infarction area in the treatment group were lower than those in the control groups, but LVEF was higher than that in the control group, and there were differences between two groups（P〈0.05）. Conclusions Calcii dibutyry-ladenosini cyclophosphas combined with nicorandil has significant clinical effect in treatment of acute ST segment elevation myocardial infarction, and can significantly improve the cardiac function indexes, and can improve the levels of myocardial injury, which has a certain clinical application value.