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-  2018 

尼可地尔对非ST段抬高型急性冠脉综合征患者PCI术中慢血流/无复流疗效及炎症因子的影响 Effects of Nicorandil on Slow/No-Reflow Phenomenon and Inflammatory Factors During Percutaneous Coronary Intervention in Patients with Non-ST Segment Elevated Acute Coronary Syndrome

Keywords: 尼可地尔,ST段抬高型急性冠脉综合征,经皮冠状动脉介入,慢血流/无复流,炎症因子

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Abstract:

目的:观察冠脉内注射尼可地尔对改善非ST段抬高型急性冠脉综合征(NSTE-ACS)患者经皮冠状动脉介入(PCI)术中慢血流/无复流及炎症因子的影响。方法:选取NSTE-ACS患者389例,其中不稳定型心绞痛(UA)患者92例,急性非ST段抬高型心肌梗死(NSTEMI)患者297例,PCI术中有60例患者靶病变血管出现慢血流/无复流[心肌梗死溶栓(TIMI)分级≤2级]。根据出现慢血流/无复流后冠脉内给药分成尼可地尔组32例和硝酸甘油组28例,观察靶血管注入药物干预后冠脉血管的TIMI血流分级、校正的TIMI血流计帧数(CTFC);观察术后ST段回位率、恶性心律失常发生率及低血压发生率;术后4d血清N末端前体B型利钠肽(NT-proBNP)水平及左心室射血分数(LVEF),术后3个月内主要心血管不良事件(MACE)发生率情况。比较干预前后两组血清炎症因子高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)的变化。结果:尼可地尔组最终造影血流TIMI 3级比例显著高于硝酸甘油组(P<0.05),而尼可地尔组CTFC显著低于硝酸甘油组(P<0.05)。尼可地尔组ST段回位率较高、恶性心律失常发生率要显著低于硝酸甘油组(P<0.05),而2组低血压发生率比较差异无统计学意义(P>0.05)。与硝酸甘油组比较,尼可地尔组术后4dNT-proBNP和LVEF明显改善(P<0.05)。2组术后3个月内MACE发生率无统计学意义(P>0.05)。干预后尼可地尔组血清hs-CRP、IL-6浓度显著低于硝酸甘油组(P<0.05)。结论:尼可地尔可显著改善NSTE-ACS患者PCI术中慢血流/无复流,降低炎症因子水平

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