尼可地尔对PCI治疗稳定性冠状动脉疾病患者心肌损伤影响的观察与分析

Observation and Analysis of the Effect of Nicorandil on Myocardial Injury in Patients with Stable Coronary Artery Disease Treated with PCI

目的探讨口服尼可地尔对行经皮冠状动脉介入治疗(PCI)稳定型心绞痛病人的心肌保护作用。方法方便选取在该院住院(2014年10月—2016年3月)需行PCI的稳定型心绞痛患者116例作为研究对象,随机分为两组,各58例。对照组入院后给予稳定型心绞痛常规治疗;在此基础上治疗组使用尼可地尔进行治疗,对其治疗效果进行分析。结果 (1)治疗组患者LA、LVEDD、LVESD、LVEDV、LVESV、LVEF分别为(3.40±0.29)cm、(2.23±0.20)cm、(3.64±0.34)cm、(144.13±16.73)mL、(69.23±12.81)mL、(0.58±0.10);对照组患者LA、LVEDD、LVESD、LVEDV、LVESV、LVEF分别为(3.37±0.27)cm、(5.52±0.58)cm、(3.46±0.30)cm、(143.43±16.70)mL、(70.23±12.86)m L、(0.45±0.09)。治疗后两组患者LA、LVESD、LVEDV、LVESV指标差异无统计学意义(t=0.338、1.775、0.132、0.246,P>0.05)。而两组患者LVEDD及LVEF指标比较数据差异有统计学意义(t=23.982、4.321,P<0.05)。(2)治疗组患者CK-MB峰值、CK-MB达峰时间、c TnI峰值、c Tn I达峰时间分别为(256.34±22.54)U/L、(12.23±1.61)h、(6.42±1.12)ng/mL、(14.03±1.73)h;对照组患者CK-MB峰值、CK-MB达峰时间、c TnI峰值、c TnI达峰时间分别为(357.35±13.240)U/L、(11.34±1.52)h、(8.43±1.35)ng/mL、(13.43±1.69)h。两组患者CK-MB峰值及c TnI峰值比较数据差异有统计学意义(t=13.240、5.124,P=0.000、0.000);两组患者CK-MB达峰时间及c TnI达峰时间比较并差异无统计学意义(t=1.797、1.109,P=0.080、0.274)。结论 PCI术前术后进行尼可地尔治疗是一种能够有效地改善心绞痛患者PCI临床疗效的手段,口服尼可地尔对行PCI的稳定型心绞痛病人有一定的心肌保护作用。

Objective To investigate the protective effect of oral nicorandil on myocardial protection in patients with stable angina pectoris undergoing percutaneous coronary intervention (PCI). Methods A total of 116 patients with stable angina requiring PCI in our hospital (October 2014 to March 2016) were convenient selected and randomly divided into 2 groups, 58 cases each. The control group received routine treatment for stable angina after admission. On this basis, the treatment group was treated with nicorandil and its therapeutic effect was analyzed. Results 1.LA, LVEDD, LVESD, LVEDV, LVESV, and LVEF in the treatment group were (3.40±0.29) cm,(2.23±0.20) cm,(3.64±0.34) cm,(144.13±16.73)mL,(69.23±12.81)mL,(0.58±0.10);control group, LA, LVEDD, LVESD, LVEDV, LVESV, LVEF were (3.37±0.27) cm,(5.52±0.58)cm,(3.46±0.30) cm,(143.43±16.70)mL,(70.23±12.86)mL,(0.45±0.09). There were no statistically significant differences in LA, LVESD, LVEDV, and LVESV between the two groups after treatment (t=0.338, 1.775, 0.132, 0.246, P>0.05). There were significant differences in the data of LVEDD and LVEF between the two groups (t=23.982, 4.321, P<0.05). 2.The CK-MB peak, CK-MB peak time, cTnI peak and cTnI peak time in the treatment group were (256.34±22.54) U/L,(12.23±1.61) h,(6.42±1.12) ng/mL,(14.03±1.73)h;CK-MB peak, CK-MB peak time, cTnI peak, and cTnI peak time in the control group were (357.35±13.240) U/L,(11.34±1.52) h,(8.43± 1.35) ng/mL,(13.43±1.69) h. There were statistically significant differences in CK-MB peak and cTnI peak between the two groups (t=13.240, 5.124, P=0.000, 0.000). There was no statistically significant significant difference in CK-MB peak time and cTnI peak time between the two groups (t=1.797, 1.109, P=0.080, 0.274). Conclusion Nicorandil treatment before and after PCI is a means to effectively improve the clinical efficacy of PCI in patients with angina pectoris. Oral nicorandil has a certain myocardial protective effect on patients with stable angina pectoris undergoing PCI.