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目的探讨尼可地尔联合替罗非班对急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后无复流现象的预防作用。方法选取2014年10月—2016年6月在百色市人民医院行PCI术的ACS患者82例,采用随机数字表法分为对照组和观察组,每组41例。对照组患者术中给予负荷剂量替罗非班,术后持续静脉泵注36 h;观察组患者在对照组基础上于术中给予负荷剂量尼可地尔,术后持续静脉滴注36 h。比较两组患者术后TIMI血流分级,术前和术后7 d血小板计数(PLT)、血清肌酸激酶同工酶(CK-MB)水平,术前和术后10 d左心室射血分数(LVEF),术后2周内不良事件发生情况。结果观察组患者术后TIMI血流分级优于对照组(P<0.05)。两组患者术前PLT、血清CK-MB水平及LVEF比较,差异无统计学意义(P>0.05);观察组患者术后7 d PLT、血清CK-MB水平低于对照组,术后10 d LVEF高于对照组(P<0.05)。观察组患者不良事件发生率低于对照组(P<0.05)。结论尼可地尔联合替罗非班对ACS患者PCI术后无复流现象具有一定预防作用,有利于改善患者心功能,减少不良事件的发生。
Objective To investigate the preventive effect of nicorandil and tirofiban on no-reflow after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods Eighty-two ACS patients undergoing PCI in Baise People’s Hospital from October 2014 to June 2016 were randomly divided into control group and observation group with 41 cases in each group. Patients in the control group were given tirofiban at a loading dose during the operation. Patients in the observation group were given a loading dose of nicorandil intraoperatively, and the patients in the observation group were given continuous intravenous infusion of 36 hours after operation. The TIMI flow classification, PLT, CK-MB level at preoperative and postoperative 7th day, the left ventricular ejection fraction (LVEF), 2 weeks after the occurrence of adverse events. Results The postoperative TIMI grade in the observation group was better than that in the control group (P <0.05). There was no significant difference in preoperative PLT, serum CK-MB level and LVEF between the two groups (P> 0.05). PLT and serum CK-MB level in the observation group at 7 d after operation were lower than those in the control group, LVEF higher than the control group (P <0.05). The incidence of adverse events in observation group was lower than that in control group (P <0.05). Conclusions Nicorandil combined with tirofiban can prevent some patients from relapse after PCI in ACS patients. It is helpful to improve the cardiac function and reduce the incidence of adverse events.