生物瓣膜置换术联合尼可地尔治疗心脏瓣膜病的效果观察

Effect of biovalvular replacement combined with nicorandil on heart valvular disease

目的探讨生物瓣膜置换术联合尼可地尔治疗心脏瓣膜病的临床疗效。方法抽取2017年1月至2019年12月新乡市中心医院收治的心脏瓣膜病患者60例,依据随机数字表法分为观察组与对照组,每组30例。对照组行生物瓣膜置换术治疗,观察组在生物瓣膜置换术基础上结合尼可地尔治疗。比较两组患者的临床治疗效果,治疗前后心功能、心肌酶、基质金属蛋白酶-2(MMP-2)和基质金属蛋白酶-9(MMP-9)水平。结果观察组总有效率(96.67%,29/30)高于对照组(73.33%,22/30),P<0.05。治疗后,两组左室射血分数(LVEF)、心排出量和心排血指数均高于治疗前(P均<0.05),且观察组LVEF、心排出量和心排血指数高于对照组(P<0.05)。治疗后,两组心肌肌钙蛋白Ⅰ(cTnI)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平均高于治疗前(P均<0.05),但观察组cTnI、CK和CK-MB水平低于对照组(P<0.05)。治疗后,两组血清MMP-2和MMP-9水平均低于治疗前(P均<0.05),且观察组血清MMP-2和MMP-9水平低于对照组(P<0.05)。结论生物瓣膜置换术联合尼可地尔治疗心脏瓣膜病效果良好,可减轻患者的心肌损伤,降低MMP-2和MMP-9水平。

Objective To investigate the effects of biovalvular replacement combined with nicorandil on heart valvular disease.Methods A total of 60 patients with valvular heart disease treated in Xinxiang Central Hospital from January 2017 to December 2019 were selected and divided into observation group and control group according to the random number table method,with 30 cases in each group.Patients in the control group were treated by biovalvular replacement,and patients in the observation group were treated with nicorandil based on the treatment of biovalvular replacement.The therapeutic effects,heart function,myocardial enzymes,matrix metalloproteinase-2(MMP-2)and matrix metalloproteinase-9(MMP-9)levels before and after treatment of the two groups were compared.Results The total effective rate in the observation group(96.67%,29/30)was higher than that in control group(73.33%,22/30),P<0.05.After treatment,the left ventricular ejection fraction(LVEF),cardiac output and cardiac output index in the two groups were higher than those before treatment(all P<0.05);and the LVEF,cardiac output and cardiac output index in the observation group were higher than those in the control group after treatment(P<0.05).After treatment,the levels of cardiac troponin(cTnI),creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)in the two groups were higher than those before treatment(all P<0.05);while the levels of cTnI,CK and CK-MB in the observation group were lower than those in the control group after treatment(P<0.05).Serum MMP-2 and MMP-9 levels in the two groups after treatment were lower than those before treatment(P<0.05);and serum MMP-2 and MMP-9 levels in the observation group were lower than those in the control group after treatment(P<0.05).Conclusions Biovalvular replacement combined with nicorandil has a good effect in the treatment of valvular heart disease,which can reduce myocardial damage and reduce the levels of MMP-2 and MMP-9.