尼可地尔对急性心肌梗死患者PCI术后心脏保护和预后的影响

Effect of Nicorandil on Cardiac Protection and Prognosis in Patients with Acute Myocardial Infarction After PCI

目的研究尼可地尔对急性心肌梗死患者经皮冠状动脉介入治疗(PCI)术后心脏保护和预后的影响。方法选取2018年1月-2020年1月在我院行PCI术的80例急性心肌梗死患者为研究对象,采用随机数字表法分为对照组和观察组,各40例。对照组采用常规抗血小板药物治疗,观察组在对照组基础上给予尼可地尔,比较两组心功能指标、血清脑钠肽(BNP)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)水平、梗死心肌灌注血流分级、并发症发生率以及临床不良反应发生情况。结果两组术后1周LVEDD、LVESD、LVEF比较,差异无统计学意义(P>0.05);两组术后1个月LVEDD、LVESD均低于术后1周,LVEF均高于术后1周,且观察组LVEDD、LVESD低于对照组,LVEF高于对照组(P<0.05);两组术后1个月血清BNP、CKMB、cTnⅠ水平均低于术前,且观察组低于对照组(P<0.05);观察组梗死心肌灌注血流2级、3级所占比例大于对照组,0级、1级所占比例小于对照组(P<0.05);观察组并发症发生率为7.50%,低于对照组的22.50%(P<0.05);观察组不良反应发生率为5.00%,与对照组的7.50%比较,差异无统计学意义(P>0.05)。结论尼可地尔对急性心肌梗死患者PCI术后心脏具有良好的保护作用,可促进心功能各指标,改善心肌血流分级,延缓心室重塑,进一步预防PCI术后并发症发生率,且不会增加不良反应发生率,有益于改善患者预后。

Objective To study the effect of nicorandil on cardiac protection and prognosis in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 80 patients with acute myocardial infarction who underwent PCI in our hospital from January 2018 to January 2020 were selected as the research objects.They were divided into control group and observation group by random number table method,with 40 cases in each group.The control group was treated with conventional antiplatelet drugs,and the observation group was given nicorandil on the basis of the control group.The cardiac function indexes,serum brain natriuretic peptide(BNP),creatine kinase isoenzyme(CK-MB),cardiac troponinⅠ(cTnⅠ)levels,infarcted myocardial perfusion blood flow grading,complication rate and clinical adverse reactions were compared between the two groups.Results There was no significant difference in LVEDD,LVESD and LVEF between the two groups at 1 week after operation(P>0.05).LVEDD and LVESD in the two groups at 1 month after operation were lower than those at 1 week after operation,LVEF was higher than that at 1 week after operation,and LVEDD and LVESD in the observation group were lower than those in the control group,LVEF was higher than that in the control group(P<0.05).The levels of serum BNP,CK-MB and cTnⅠin the two groups at 1 month after operation were lower than those before operation,and those in the observation group were lower than those in the control group(P<0.05).The proportion of grade 2 and grade 3 of myocardial perfusion blood flow in the observation group was higher than that in the control group,and the proportion of grade 0 and grade 1 was lower than that in the control group(P<0.05).The incidence of complications in the observation group was 7.50%,which was lower than 22.50%in the control group(P<0.05).The incidence of adverse reactions in the observation group was 5.00%,compared with 7.50%in the control group,the difference was not statistically significant(P>0.05).Conclusion Nicorandil has a good protective effect on the heart after PCI in patients with acute myocardial infarction.It can promote the indexes of cardiac function,improve the classification of myocardial blood flow,delay ventricular remodeling,and further prevent the incidence of complications after PCI without increasing the incidence of adverse reactions,which is beneficial to improve the prognosis of patients.