尼可地尔对老年急性ST段抬高型心肌梗死患者BNP水平与冠脉血流影响的研究

发布时间：2018-08-07 19:48

【摘要】：目的:探讨尼可地尔对老年急性ST段抬高型心肌梗死(STEMI)患者脑钠肽(BNP)水平与冠脉血流情况的影响。方法:选取我院于2013年1月至2015年10月期间收治的80例行急诊经皮冠状动脉介入(PCI)术的STEMI患者,采用简单随机抽样法平均分为两组:观察组围手术期静脉滴注尼可地尔,对照组围手术期静脉滴注同体积生理盐水,观察两组患者术后BNP水平与冠脉血流情况。结果:观察组37例(92.5%)患者术后90 min心电图显示,心电图ST段变化(sum STR)回落高于50%,对照组32例(80.0%)sum STR回落高于50%,卡方检验表明差异有统计学意义(χ2=9.89,P=0.00);观察组术后TIMI3级血流和心肌灌注率分别为92.5%和87.5%,显著高于对照组(82.5%,77.5%)(P0.05);两组患者术后1周和4周时血浆BNP水平较治疗前显著下降(P0.05),观察组术后1周和4周的血浆BNP水平显著低于对照组(P0.05);观察组术后1周和4周的LVEF显著高于对照组,差异有统计学意义(P0.05);两组患者术后1周的LVEF、LVESD及术后4周的LVEF、LVEDD和LVESD之间差异有统计学意义(P0.05),且观察组术后4周的LVEF和LVEDD显著优于术后1周时水平,差异具有统计学意义(P0.05)。观察组随访3个月内不良事件率为10.0%,显著低于对照组(20.0%)(P0.05)。结论:围手术期静脉滴注尼可地尔能够有效改善STEMI患者术后冠脉血流情况,降低血浆BNP水平,避免心功能损伤,降低心脏不良事件发生率,改善预后。
[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.
【作者单位】：重庆市三博江陵医院;
【分类号】：R542.22

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