尼可地尔对急性ST段抬高型心肌梗死患者行急诊经皮冠状动脉介入治疗后室性心律失常的影响

Clinical value of ultrasound guided percutaneous thermal ablation in the treatment of thyroid nodules associated with intra cystic hemorrhage

目的探讨尼可地尔对急诊经皮冠状动脉介入治疗术后急性ST段抬高型心肌梗死患者室性心律失常的影响。方法选取宝鸡市中心医院心内科2016年1月～2017年1月收治的行急诊经皮冠状动脉介入治疗的急性ST段抬高型心肌梗死患者120例作为研究对象，按随机信封法将其分为观察组和对照组，每组60例。所有患者入院后均给予常规处理，行急诊经皮冠状动脉介入术治疗，观察组在此基础上于术前30min给予尼可地尔治疗。比较2组患者术后室性心律失常发生情况、术前和术后24h、术后72hQT间期离散度（QTd）、校正的QT间期离散度（QTcd）。结果术后观察组室性早搏发生率和非持续性室性心动过速发生率均显著低于对照组（P＜0.05），持续性室速+室颤发生率低于对照组，但组间比较差异无统计学意义。观察组术后24h和术后72h的QTd、QTcd均显著低于对照组，比较差异有统计学意义（P＜0.05）。结论尼可地尔对急诊经皮冠状动脉介入治疗术后急性ST段抬高型心肌梗死患者可发挥心肌保护作用，减少术后室性心律失常发生。

Objective To investigate the effect of nicorandil on ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction(STEMI)treated with emergent percutaneous coronary intervention(PCI).Methods120cases of patients with acute ST segment elevationmyocardial infarction underwent emergency percutaneous coronary interventional treatment from January2016to January2017were selected as the research objects,and divided into the observation group and the control group,60cases in each group.All patients were given routine treatment after admission,and the patient was treated by the percutaneous coronary interventional therapy.The observation group was treated with nicodiel at30min before the operation.The duration of ventricular arrhythmias occurred in the two groups,the preoperative and postoperative24h,72h QT interphase dispersion(QTd)and the QT interphase dispersion(QTcd)were compared.Results After operation,the incidence of ventricular premature beat and non-durable incidence of ventricular tachycardia in the observation group were significantly lower than the control group(P<0.05),sustained ventricular tachycardia and ventricular fibrillation incidence rate were lower than the control group,but there was no statistically significance between two groups.The QTd and QTcd of24h and72h after operation in the observation group were significantly lower than the control group,and the difference was statistically significant(P<0.05).Conclusion Nicorandil may play a cardioprotective effect in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention,and reduce the incidence of postoperative ventricular arrhythmia.