發(fā)布時(shí)間：2018-08-07 19:48

【摘要】：目的:探討尼可地爾對老年急性ST段抬高型心肌梗死(STEMI)患者腦鈉肽(BNP)水平與冠脈血流情況的影響。方法:選取我院于2013年1月至2015年10月期間收治的80例行急診經(jīng)皮冠狀動(dòng)脈介入(PCI)術(shù)的STEMI患者,采用簡單隨機(jī)抽樣法平均分為兩組:觀察組圍手術(shù)期靜脈滴注尼可地爾,對照組圍手術(shù)期靜脈滴注同體積生理鹽水,觀察兩組患者術(shù)后BNP水平與冠脈血流情況。結(jié)果:觀察組37例(92.5%)患者術(shù)后90 min心電圖顯示,心電圖ST段變化(sum STR)回落高于50%,對照組32例(80.0%)sum STR回落高于50%,卡方檢驗(yàn)表明差異有統(tǒng)計(jì)學(xué)意義(χ2=9.89,P=0.00);觀察組術(shù)后TIMI3級血流和心肌灌注率分別為92.5%和87.5%,顯著高于對照組(82.5%,77.5%)(P0.05);兩組患者術(shù)后1周和4周時(shí)血漿BNP水平較治療前顯著下降(P0.05),觀察組術(shù)后1周和4周的血漿BNP水平顯著低于對照組(P0.05);觀察組術(shù)后1周和4周的LVEF顯著高于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者術(shù)后1周的LVEF、LVESD及術(shù)后4周的LVEF、LVEDD和LVESD之間差異有統(tǒng)計(jì)學(xué)意義(P0.05),且觀察組術(shù)后4周的LVEF和LVEDD顯著優(yōu)于術(shù)后1周時(shí)水平,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組隨訪3個(gè)月內(nèi)不良事件率為10.0%,顯著低于對照組(20.0%)(P0.05)。結(jié)論:圍手術(shù)期靜脈滴注尼可地爾能夠有效改善STEMI患者術(shù)后冠脈血流情況,降低血漿BNP水平,避免心功能損傷,降低心臟不良事件發(fā)生率,改善預(yù)后。
[Abstract]:Aim: to investigate the effects of nicorandil on brain natriuretic peptide (BNP) and coronary blood flow in elderly patients with acute St segment elevation myocardial infarction (STEMI). Methods: from January 2013 to October 2015, 80 patients with STEMI undergoing percutaneous coronary intervention (PCI) were randomly divided into two groups: the observation group received intravenous drip of nicorandil during perioperative period. In the control group, the BNP level and coronary blood flow were observed by intravenous drip of the same volume of normal saline in perioperative period. Results: the electrocardiogram of 37 patients (92.5%) in the observation group was 90 min after operation. St segment (sum STR) decreased more than 50% in the control group (80.0%), the chi-square test showed the difference was statistically significant (蠂 ~ 2 / 9.89), the TIMI3 grade blood flow and myocardial perfusion rate in the observation group were 92.5% and 87.5%, respectively, which were significantly higher than those in the control group (82.5%) (P0.05). Plasma BNP levels decreased significantly in both groups at 1 and 4 weeks after operation (P0.05), plasma BNP levels in observation group were significantly lower than those in control group at 1 and 4 weeks after operation (P0.05), LVEF in observation group at 1 and 4 weeks after operation was significantly higher than that in control group. There was significant difference between the two groups (P0.05). The difference between the two groups was statistically significant (P0.05). The LVEF and LVEDD in the observation group were significantly better than those at the 1st week after operation (P0.05). 4 weeks after operation, there was a significant difference between the two groups (P0.05). 4 weeks after operation, the level of LVEF and LVEDD in the observation group was significantly higher than that at the first week after operation (P0.05). The rate of adverse events in the observation group was 10.0, which was significantly lower than that in the control group (20.0%) (P0.05). Conclusion: intravenous drip of nicorandil in perioperative period can effectively improve coronary blood flow, decrease plasma BNP level, avoid cardiac function injury, reduce incidence of adverse cardiac events and improve prognosis in patients with STEMI.
【作者單位】： 重慶市三博江陵醫(yī)院;
【分類號】：R542.22

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