尼可地尔联合替罗非班对急性心肌梗死PCI术后心肌微循环灌注及氧化应激损伤的影响

Effects of nicorandil combined with tirofiban on myocardial microcirculation perfusion and oxidative stress injury after PCI for acute myocardial infarction

目的探讨尼可地尔联合替罗非班对急性心肌梗死经皮冠状动脉介入(PCI)术后心肌微循环灌注及氧化应激损伤的影响。方法选取2018年8月至2020年8月收治的行PCI术的急性心肌梗死患者90例,以抽签法将其随机分为对照组和观察组,各45例。对照组采用替罗非班治疗,观察组采用尼可地尔联合替罗非班治疗。比较两组的心肌微循环灌注指标、氧化应激损伤指标及心功能指标。结果治疗后,观察组的TIMI血流帧幅数低于对照组和治疗前,TIMI血流分级高于对照组和治疗前(P<0.05)。治疗后,两组的MDA水平均降低,LVESD、LVEDD均减小,SOD、GSH-Px水平及LVEF均升高,且观察组优于对照组(P<0.05)。结论急性心肌梗死PCI术后采用尼可地尔联合替罗非班治疗,有助于提高患者的心肌微循环灌注改善效果,进一步减轻氧化应激损伤,促进心功能恢复。

Objective To explore the effects of nicorandil combined with tirofiban on myocardial microcirculation perfusion and oxidative stress injury after percutaneous coronary intervention(PCI)for acute myocardial infarction.Methods Ninety patients with acute myocardial infarction who underwent PCI from August 2018 to August 2020 were randomly divided into control group and observation group by drawing lots,with 45 cases in each group.The control group was treated with tirofiban,and the observation group was treated with nicorandil combined with tirofiban.The indexes of myocardial microcirculation perfusion,oxidative stress injury and cardiac function were compared between the two groups.Results After treatment,the number of TIMI blood flow frames in the observation group was lower than that in the control group and before treatment,and the TIMI blood flow grade was higher than that in the control group and before treatment(P<0.05).After treatment,the level of MDA in the two groups decreased,LVESD and LVEDD reduced,the levels of SOD and GSH-Px increased,and those in the observation group were better than the control group(P<0.05).Conclusion Nicorandil combined with tirofiban after PCI for acute myocardial infarction is helpful to improve the improvement effect of myocardial microcirculation perfusion,further reduce oxidative stress injury,and promote the recovery of cardiac function.