尼可地尔在治疗心绞痛及PCI术中的临床应用

Clinical Application of Nicorandil in the Treatment of Angina Pectoris and PCI

目的观察尼可地尔在治疗心绞痛及PCI术中对患者临床症状的改善情况。方法 2017年7月至2018年1月曾于我院或外院行经皮冠状动脉介入(PCI)治疗后反复发作心绞痛及PCI术中出现无复流/慢复流的48例冠心病患者,根据术中及术后是否应用尼可地尔治疗随机分为2组(尼可地尔组与常规组),两组患入院后均给予基础药物治疗,术后给予冠心病二级预防。尼可地尔组在上述治疗基础上,术中出现无复流/慢复流给予尼可地尔4 mg(可多次给药);术后继续使用尼可地尔5-10天,用法:0.9%生理盐水30 mL+尼可地尔12 mg微量泵泵入(15 mL/h)持续2-6 h。结果尼可地尔组总有效率为96.0%,优于对照组56.5%;两组比较差异显著,具有统计学意义(P<0.05)。结论尼可地尔可以显著地改善稳定性以及不稳定性心绞痛患者症状,改善生活质量,同时,降低冠心病患者全因病死率,改善长期预后。另外,在冠心病介入治疗中;尼可地尔可以显著改善无复流/慢复流现象。

Objective To observe the improvement of clinical symptoms during the treatment of angina pectoris and PCI. Methods From July 2017 to January 2018, 48 patients with coronary heart disease who had been treated with percutaneous coronary intervention(PCI) for recurrent angina pectoris and no reflow/slow reflow during PCI were studied. According to the intraoperative and postoperative application of nicorandil, the two groups were randomly divided into two groups: nicorandil group and routine group. Both groups were treated with basic drugs after admission, and secondary prevention of coronary heart disease was given after operation. On the basis of the above treatment, no reflow/slowness occurred in the nicorandil group. After reflow, nicorandil(4 mg) was given continuously for 5-10 days, followed by 0.9% normal saline, 30 mL, nicorandil 12 mg micropump(15 mL/h) for 2-6 hours. Results The total effective rate of nicorandil group was 96.0, which was better than that of the control group(56.5%), and the difference between the two groups was significant(P<0.05). Conclusions Nicorandil can significantly improve the stability and symptoms of patients with unstable angina pectoris improve the quality of life at the same time reduce the all-cause mortality of patients with coronary heart disease and improve the long-term prognosis. In addition, Nicorandil can significantly improve no reflow/slow reflow in coronary intervention therapy.