预防性注射尼可地尔是否可以减少急性 STEMI 患者PCI 期间无复流现象

doi:10.3969/j.issn.1001-8131.2022.05.003

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摘要目的探讨预防性冠状动脉内给予尼可地尔是否可以减少接受 PCI 的 STEMI 患者的 NRP 发生率。方法选取我院接受治疗的280例患有持续急性 STEMI 并适合住院 PCI 的患者,依据双盲法分为观察组（140例）与对照组（140例）。观察组冠状动脉内给予注射2 mg 尼可地尔,对照组给予注射 2 mL 生理盐水,观察两组NRP 的发生率、术后7d NT-proBNP、 cTnT 和 CK-MB 的水平和术后7dLVEF（%）、WMSI,以及术后低血压人数及主要心脏不良事件。结果观察组术中NRP发生率24%明显小于对照组术中NRP发生率50%（P<0.05）。术后7d,观察组NT-proBNP（607.31±82.20）ng·L^-1、CK-MB（328.00±77.95）U·L^-1、CTnI（3.14±0.55）μg·L^-1均明显小于对照组NT-proBNP（734.47±82.60）ng·L^-1、CK-MB（440.89±88.94）U·L^-1、CTnI（4.48±1.00）μg·L^-1（P<0.05）。术前,两组患者NT-proBNP、CK-MB、CTnI对比差异无统计学意义（P>0.05）。术后7d,观察组LVEF明显大于对照组（P<0.05）。术后7d,观察组WMSI明显小于对照组（P<0.05）。术前,两组患者LVEF、WMSI对比差异无统计学意义（P>0.05）。观察组术后低血压0例、主要心脏不良事件6例均明显小于对照组术后低血压14例、主要心脏不良事件28例（P<0.05）。结论研究结果将确定预防性冠状动脉内给予尼可地尔以减少急性 STEMI 患者 PCI 期间 NRP 发生的有效性。

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	周灿

关键词 ：尼可地尔, 无复流现象, 经皮冠状动脉介入治疗, ST段抬高型心肌梗死

Abstract：Objective To investigate whether prophylactic intracoronary administration of nicodil can reduce the incidence of NRP in STEMI patients undergoing PCI. Methods A total of 280 patients with persistent acute STEMI and suitable for inpatient PCI who received treatment were selected and divided into observation group（140 cases）and control group（140 cases）according to the double-blind method.The incidence of NRP,interleukin 6 and the levels of hs-CRP,cTnT and CK-MB were observed every 4 hours before and after PCI.And major adverse cardiovascular events at day 30. Results The incidence of NRP in the observation group was 24%,which was significantly lower than that in the control group（P&LT;0.05）.Seven days after surgery,The observation group NT-proBNP（607.31±82.20）ng·L^-1,CK-MB（328.00±77.95）U·L^-1,cTnI（3.14±0.55）μg·L^-1 were significantly less than the control group NT-proBNP（734.47±82.60）ng·L^-1,CK-1MB（440.89±88.94）U·L^-1,cTnI（4.48±1.00）μg·L^-1（P<0.05）.Before surgery,there were no significant differences in NT-proBNP,CK-MB and cTnI between the two groups（P&GT;0.05）.At 7 days after operation,LVEF in the observation group was significantly higher than that in the control group（P&LT;0.05）.At 7 days postoperatively,WMSI in the observation group was significantly lower than that in the control group（P&LT;0.05）.Before surgery,there was no significant difference in LVEF and WMSI between the two groups（P&GT;0.05）.The observation group（0 cases of hypotension and 6 cases of major cardiac adverse events）were significantly lower than the control group（14 cases of hypotension and 28 cases of major cardiac adverse events）（P<0.05）. Conclusion The results of this study will determine the effectiveness of prophylactic intracoronary administration of nicodil to reduce the incidence of NRP during PCI in patients with acute STEMI.

Key words： Nicodil No reflow phenomenon Percutaneous coronary intervention ST-segment elevation myocardial infarction

收稿日期: 2021-08-03

PACS:

R543.3+1

引用本文:

周灿. 预防性注射尼可地尔是否可以减少急性 STEMI 患者PCI 期间无复流现象[J]. 哈尔滨医药, 2022, 42(5): 6-8.
Zhou Can. Can Preventive Injection of Nicorandil Reduce No Reflow During PCI in Patients With Acute STEMI. journal1, 2022, 42(5): 6-8.

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http://www.hrbyybjb.org.cn/CN/10.3969/j.issn.1001-8131.2022.05.003 或 http://www.hrbyybjb.org.cn/CN/Y2022/V42/I5/6

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