通脉胶囊联合尼可地尔对急性心肌梗死病人PCI术后冠状动脉血流及并发症的影响

Influences of Tongmai Capsule Combined with Nicorandil on Coronary Blood Flow and Complications in Patients with Acute Myocardial Infarction after PCI

目的探讨通脉胶囊联合尼可地尔对急性心肌梗死(AMI)病人经皮冠状动脉介入术(PCI)后冠状动脉血流及并发症的影响。方法选取2016年3月-2017年9月在我院心内科住院行PCI手术的AMI病人126例,采用随机数字表法将病人分为对照组与试验组,每组63例。对照组在PCI术后服用常规治疗药物,试验组在常规治疗药物的基础上加用通脉胶囊和尼可地尔。所有病人均在PCI术后第1天开始服用相关药物,持续3个月。观察校正的心肌梗死溶栓(TIMI)血流计帧数(CTFC)、术前及术后的TIMI血流分级、90 min内ST段回落率、心血管不良事件及PCI术后并发症发生情况。结果试验组90 min内ST段回落率较对照组增高,CTFC较对照组降低(P<0.05);两组术前TIMI血流分级比较,差异无统计学意义(P>0.05);两组术后TIMI血流分级比较,差异有统计学意义(P<0.05);试验组反复性心绞痛发生率、心源性猝死发生率和非致命性心肌梗死发生率与对照组比较差异无统计学意(P>0.05);试验组再灌注心律失常发生率明显低于对照组(P<0.05),牙龈出血、穿刺点血肿、便血和尿血发生率与对照组比较,差异均无统计学意义(P>0.05)。结论 PCI术后在给予常规药物治疗的基础上加用通脉胶囊和尼可地尔,可有效改善PCI术后冠状动脉血流灌注状况,同时也能减少心血管不良事件及PCI术后并发症的发生率。

Objective To investigate the effect of Tongmai capsule combined with nicorandil on coronary blood flow and complications in patients with acute myocardial infarction after PCI.Methods One hundred and twenty-six patients with acute myocardial infarction(AMI) came from cardiovascular department of our hospital,who underwent percutaneous coronary intervention(PCI)were selected from March 2016 to September 2017.The patients were divided into control group and experimental group by random number method,with 63 cases in each group.The patients in the control group were given conventional therapy after PCI,the patients in the experimental group were given Tongmai capsule and nicorandil based on conventional therapy for 3 months.The corrected TIMI frame count(CTFC),TIMI blood flow,90 min ST-segment resolution,postoperative complications,and adverse cardiovascular events were observed.Results The decrease of ST-segment resolution in 90 min in the experimental group was higher than that in the control group,and the CTFC in the experimental group was lower than that in the control group(P<0.05).There was no statistic difference in the level of TIMI blood flow between two groups before operation(P>0.05).There was significant difference in TIMI grade between two groups after operation(P<0.05).There were no statistically significant difference in the incidence rate of recurrent angina,the incidence of sudden cardiac death and non-fatal myocardial infarction between two groups(P>0.05).The incidence of reperfusion arrhythmia in the experimental group were significantly lower than those in the control group(P<0.05).There were no significant difference in the rate of gingival bleeding,puncture point hematoma,hematuria and hematochezia between two groups(P>0.05).Conclusion Tongmai capsule combined with nicorandil could effectively improve coronary perfusion after PCI,reduce the incidence of adverse cardiovascular events and complications.