天津医药

• 药物临床观察 • 上一篇    下一篇

尼可地尔对PCI相关心肌损伤及再发心绞痛症状的影响

杨树涵1,王成1,刘艳宾2,韩明磊2   

  1. 1. 新乡市中心医院
    2. 河南省新乡市中心医院心内一科
  • 收稿日期:2013-12-16 修回日期:2014-05-19 出版日期:2014-10-15 发布日期:2014-10-15
  • 通讯作者: 杨树涵

Protective effect of nicorandil on myocardial injury and recurrent angina after percutaneous coronary intervention

  1. 1. e First Department of Cardiology, Xinxiang Central Hospital, Henan 453000, China
    2.
  • Received:2013-12-16 Revised:2014-05-19 Published:2014-10-15 Online:2014-10-15
  • Contact: YANG Shu han

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摘要：

【摘要】目的 观察经皮冠脉介入治疗（PCI）术前应用尼可地尔对不稳定型心绞痛患者PCI 相关心肌损伤及术后长期应用对心绞痛的影响。方法 选择行PCI 的不稳定型心绞痛患者91 例，随机分为尼可地尔组和常规组，常规组患者行优化冠心病药物治疗，尼可地尔组在此基础上给予尼可地尔5 mg 口服，每日3 次，应用1 周行PCI。术前，术后6、18、24 h 检测血清肌酸激酶同工酶（CK-MB）和心肌肌钙蛋白I(cTnI)，术后6 个月随访心绞痛缓解情况及主要心血管不良事件。结果 最终有75 例完成研究，尼可地尔组37 例，常规组38 例，2 组患者在住院期间和术后随访时均未发生死亡、心肌梗死、脑卒中，术后尼可地尔组血清CK-MB 和cTnI 水平较常规组降低（P < 0.05），尼可地尔组患者心绞痛症状缓解较常规组明显(P < 0.05)。结论 尼可地尔能减轻不稳定型心绞痛PCI 相关心肌损伤，长期应用对心绞痛有良好的缓解作用。

关键词: 经皮冠脉介入治疗, 肌钙蛋白Ⅰ, 尼可地尔, 再发心绞痛

Abstract:

[Abstract] Objective  To explore the protective effect of pre-operation administration of nicorandil on myocardial injury and recurrent angina in patients with unstable angina pectoris who underwent percutaneous coronary intervention (PCI). Methods  A total of 91 patients with unstable angina pectoris were admitted for PCI and randomly divided into 2 groups who either received nicorandil（5 mg tid）or not for 7 days prior to the procedure and routine dose of nicorandil (5mg tid) after it．The concentrations of creatine kinase MB (CK-MB) and cardiac troponin I(cTnI) were compared between two groups before PCI and 6 hours, 18 hours and 24 hours after PCI；Recurent angina and major adverse cardiac events，includ? ing death，re-infarction and stroke at 6 months after the procedure were also chased and compared.  Results In total, 75 patients who were successfully undergone elective PC1 were finally enrolled，among whom 37 cases were in nicorandil group and 38 cases were in routine group． Post-procedural levels of CK-MB and cTnI significantly reduced in the nicorandil group between 6～24 h (P < 0.05) compared those in routine group．At 6 months follow-up，symptoms of recurrent angina after PCI were significantly relieved in the nicorandil group compared with that in routine group (P < 0.05)．Conclusion nicorandil can limit the PCI-induced myocardial injury and relieve the symptoms of recurrent angina after PCI in patients with unstable angina．

Key words: Percutaneous Coronary Intervention, troponin Ⅰ, Nicorandil, recurrent angina