作　　者： (魏立业）; (夏岳）; (戚国庆）; (杨志瑜）; (赵红亮）;

机构地区： 河北医科大学第一医院心内三科,河北石家庄050031

出　　处： 《中国急救医学》 2017年第9期800-802,共3页

摘　　要： 目的 研究尼可地尔对行择期经皮冠状动脉介入治疗（PCI）的急性非ST段抬高型心肌梗死（NSTEMI）患者心肌灌注水平的影响。方法 60例NSTEMI患者随机分成对照组（CON组）、尼可地尔组（NIC组）。药物治疗10 d后行冠状动脉造影及PCI治疗，主要观察指标包括：校正TIMI计帧数（CTFC）、心肌染色分级（MBG）。随访观察6个月内主要心血管不良事件（MACEs）的发生情况。结果 两组患者基线特征差异无统计学意义（P〉0.05）。术后两组CTFC比较，NIC组（18.4±3.6）帧明显小于CON组（25.3±2.2）帧，差异有统计学意义（P〈0.01）。术后MBG 3级者NIC组为26例占86.7%，CON组为18例占60.0%，两组比较差异有统计学意义（P〈0.05）。随访6个月NIC组患者MACEs发生率明显低于CON组（10.0% vs. 26.7%），两组比较差异有统计学意义（P〈0.05）。结论 尼可地尔可以改善NSTEMI患者择期PCI后心肌灌注水平。 Objective To assess the effect of nicorandil on myocardial perfusion in patients with NSTEMI after elective PCI. Methods 60 patients with NSTEMI were randomly assigned to two groups： control group （CON） and nicorandil group （NIC）. The coronary angiography and PCI were performed after 10 days. The corrected TIMI frame count （ CTFC ） and myocardial blush grade （ MBG ） were calculated. Patients were followed up for 6 months. Major adverse cardiac events （MACEs） were also measured. Results There were no significant differences in baseline characteristics between the two groups （P 〉 0. 05）. The CTFC parameter in NIC group was significantly lower than that in CON group [ （ 18.4 ± 3.6） vs. （25.3 ± 2.2 ） , P 〈 0.01 ]. The ratio of final MBG grade - 3 was significantly higher （P 〈0.05 ） in NIC group （86.7%） relative to CON group （60.0%）. Patients were followed up for 6 months and the occurrence of MACEs in NIC group was significantly lower than that in CON group （ 10.0% vs. 26.7% , P 〈 0.05 ）. Conclusion Nicorandil can improve the situation of myocardial reperfusion after elective PCI in patients with NSTEMI.

关 键 词： 急性心肌梗死 经皮冠状动脉介入治疗 冠脉微循环 尼可地尔