尼可地尔预注射对AMI患者PCI术后心功能及临床预后的影响

Influence of nicorandil pre-injection on cardiac function and clinical prognosis in AMI patients after PCI

目的:研究尼可地尔预注射对急性心肌梗塞(AMI)患者PCI术后心功能及预后的影响.方法:2016年1月~2018年1月我院接受PCI的AMI患者102例被随机均分为常规PCI组与尼可地尔组(在常规PCI组基础上接受尼可地尔预注射).两组均随访6个月.观察比较两组术后即刻与术后6个月的心脏指数(CI)、LVEF、左室收缩末期容积指数(LVESVI)、左室舒张末期容积指数(LVEDVI)、住院期间不良心脏事件发生率及随访期间临床预后情况.结果:PCI术后即刻,尼可地尔组CI显著高于常规PCI组,LVESVI显著低于常规PCI组(P均=0.001).与常规PCI组比较,术后6个月,尼可地尔组CI[(2.27±0.55)L·min-1·m-2比(2.78±0.71)L·min-1·m-2]、LVEF[(50.43±4.66)%比(53.26±5.31)%]升高更显著,LVESVI[(51.99±5.21)ml/m2比(40.39±4.91)ml/m2]、LVEDVI[(102.14±8.57)ml/m2比(87.88±6.75)ml/m2]降低更显著(P均<0.01).尼可地尔组住院期间不良心脏事件发生率显著低于常规PCI组(15.69%比33.33%,P=0.038).随访期间,尼可地尔组再入院发生率显著低于常规PCI组(3.92%比19.61%,P=0.014).结论:尼可地尔预注射可显著改善AMI患者PCI术后的临床预后,改善心功能,降低不良心脏事件发生率.

Objective:To study influence of nicorandil pre-injection on cardiac function and prognosis in patients with acute myocardial infarction(AMI) after PCI. Methods:A total of 102 AMI patients undergoing PCI in our hospital from Jan 2016 to Jan 2018 were randomly and equally divided into routine PCI group and nicorandil group(received nicorandil pre-injection based on routine PCI group). Both groups were followed up for six months. Cardiac index(CI), LVEF, left ventricular end-systolic volume index(LVESVI) and left ventricular end-diastolic volume index(LVEDVI) instant and six-month after PCI, incidence rate of adverse cardiac events during hospitalization and clinical prognosis during follow-up were observed and compared between two groups. Results:Instant after PCI, CI of nicorandil group was significantly higher than that of routine PCI group, and LVESVI was significantly lower than that of routine PCI group(P=0.001 both).Compared with routine PCI group, six months after PCI, there were significant rise in CI [(2.27±0.55)L·min-1·m-2 vs.(2.78±0.71)L·min-1·m-2] and LVEF [(50.43±4.66)% vs.(53.26±5.31)%], and significant reductions in LVESVI [(51.99±5.21) ml/m2 vs.(40.39±4.91)ml/m2] and LVEDVI [(102.14±8.57) ml/m2 vs.(87.88±6.75)ml/m2] in nicorandil group(P<0.01 all). Incidence rate of adverse cardiac events during hospitalization of nicorandil group was significantly lower than that of routine PCI group(15.69% vs. 33.33%, P=0.038). During follow-up, rehospitalization rate of nicorandil group was significantly lower than that of routine PCI group(3.92% vs. 19.61%, P=0.014). Conclusion:Nicorandil pre-injection can significantly improve clinical prognosis and cardiac function, and reduce incidence rate of adverse cardiac events in AMI patients after PCI.