尼可地尔对不稳定型心绞痛患者 PCI 术后心肌损伤的影响

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【目的】探讨尼可地尔对不稳定型心绞痛(UA )患者行冠状动脉介入术(PCI)后心肌损伤的影响。【方法】选择2012年1月至2014年12月本院收治的确诊为U A患者90例。用随机数表法分为对照组和观察组,每组各45例,对照组给予常规优化冠心病药物治疗,观察组则在此基础上口服尼可地尔。比较两组患者的心血管不良事件、临床疗效、血清肌钙蛋白I(cTnI)和磷酸肌酸激酶同工酶(CK‐MB)水平及心功能。【结果】两组患者在住院及随访期间均为未发生脑卒中、再发心肌梗死和死亡等心血管不良事件。观察组患者治疗效果显效、有效例数多于对照组,无效人数少于对照组,整体疗效明显优于对照组,差异具有统计学意义( P <00.5)。两组患者术前及术后12 h血清cTnI和CK‐MB水平比较差异无统计学意义( P >00.5),而术后24 h ,观察组患者血清cT‐nI和CK‐MB水平明显低于对照组,差异具有统计学意义( P <00.5)。两组患者术后及术后1周的左室射血分数(LVEF)比较差异无统计学意义( P >00.5),而术后1个月,观察组患者的LVEF值明显高于对照组,差异具有统计学意义( P <00.5)。【结论】 UA患者行PCI术前应用尼可地尔可以缓解心绞痛症状,减轻心肌损伤,改善心功能。“,”Objective] To study the clinical effect of Nicorandil on myocardial injury of unstable angina pectoris pa‐tients undergoing percutaneous coronary artery intervention (PCI) .[Methods]The 90 cases of patients with unstable an‐gina were selected who hospitalized and diagnosed in our hospital from January 2012 to December 2014 .They were divided into control group and observation group by the random number table method ,each group had 45 cases .The control group was given conventional optimization of coronary heart disease ,and the observation group was given oral Nicole on the basis of t.he control group .Cardiovascular adverse events ,clinical efficacy ,serum cardiac troponin I(cTnI ) and creatine kinase isoenzyme (CK‐MB) levels and heart function were compared between the two groups .[Results]During hospitali‐zation and follow‐up period ,cerebral apoplexy ,re‐occurring myocardial infarction ,death and other adverse cardiovascu‐lar events were not occurred in patients of the two groups .Effective treatment ,the effective number of cases of the ob‐servation group were more than those of the control group ;the number of invalid was less than that of the control group , the overall efficacy was better than the control group ,the difference was statistically significant ( P 0 0.5) ,At 24 h after operation ,the serum levels of cTn and CK‐MB in the observation group were significantly lower than those in the control group ,the difference was statistically significant ( P 0 0.5) ,and one month after the operation ,the LVEF values of the observation group were significantly higher than those of the control group ( P >0 0.5) ,the difference was statistically significant ( P <0 0.5)[.Conclusion]Before preoperative coronary artery interven‐tional therapy ,Nicole treatment on unstable angina patients can relieve angina symptoms ,reduce myocardial injury and improve heart function .
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