中国循证心血管医学杂志2024，Vol.16Issue(12) ：1479-1482.DOI:10.3969/j.issn.1674-4055.2024.12.15

预防性冠状动脉内注射瑞替普酶、尼可地尔对STEMI患者PCI术后冠状动脉血流的影响分析

Influence of prophylactic intra-coronary injection of reteplase and nicorandil on coronary blood flow in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention

梁鹏 周泓宇 黎百志 何小姣
中国循证心血管医学杂志2024，Vol.16Issue(12) ：1479-1482.DOI:10.3969/j.issn.1674-4055.2024.12.15
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  • 维普
  • 万方数据

预防性冠状动脉内注射瑞替普酶、尼可地尔对STEMI患者PCI术后冠状动脉血流的影响分析

Influence of prophylactic intra-coronary injection of reteplase and nicorandil on coronary blood flow in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention

梁鹏 1周泓宇 1黎百志 1何小姣1
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作者信息

  • 1. 402360 重庆,重庆市大足区人民医院心血管内科
  • 折叠

摘要

目的 分析预防性冠状动脉内注射瑞替普酶、尼可地尔对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后冠状动脉血流的影响.方法 选择2021年1月至2023年1月于重庆市大足区人民医院就诊的136例STEMI患者,根据治疗方法不同分为:对照组69例采用预防性冠状动脉内注射硝酸甘油,观察组67例采用预防性冠状动脉内注射瑞替普酶、尼可地尔.比较两组患者心肌梗死溶栓治疗(TIMI)血流分级、心功能参数、血清炎性因子、不良心血管事件总发生率.结果 治疗后观察组TIMI血流分级2级、3级均高于对照组(47.76％vs.42.03％;31.34％vs.14.49％),差异有统计学意义(P<0.05).观察组左室射血分数(LVEF)高于对照组,左室舒张末期内径(LVEDD)、血清心肌肌钙蛋白Ⅰ(cTnI)、肌酸激酶同工酶(CK-MB)均低于对照组(P<0.05).观察组治疗后血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)均低于对照组(P<0.05).观察组不良心血管事件总发生率低于对照组(1.49％vs.11.59％,P<0.05).结论 STEMI患者预防性冠状动脉内注射瑞替普酶、尼可地尔有效改善PCI术后TIMI血流分级和心功能,减轻炎症反应,预防心血管不良事件发生.

Abstract

Objective To analyze the influence of prophylactic intra-coronary injection of reteplase and nicorandil on coronary blood flow in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).Methods STEMI patients (n=136) were chosen from People's Hospital of Dazu District of Chongqing City from Jan.2021 to Jan.2023.The patients were divided,according different therapies,into control group (n=69) treated with prophylactic intra-coronary injection of nitroglycerin,and observation group (n=67) treated with prophylactic intra-coronary injection of reteplase and nicorandil.The indexes of flow grades of thrombolysis in myocardial infarction (TIMI),heart function,serum inflammatory factors and total incidence of major adverse cardiovascular events (MACE) were compared between 2 groups.Results After treatment,the percentages of grades 2 and 3 of TIMI flow grades were higher (47.76％ vs.42.03％;31.34％ vs.14.49％,P＜0.05),left ventricular ejection fraction (LVEF) was higher,and left ventricular end-diastolic diameter (LVEDD),cardiac troponin I (cTnI) and creatine kinase-MB isoenzyme (CK-MB) were lower (P＜0.05) in observation group than those in control group.The levels of interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) were lower in observation group than those in control group (P＜0.05).The total incidence of MACE was lower in observation group than that in control group (1.49％ vs.11.59％,P＜0.05).Conclusion The prophylactic intra-coronary injection of reteplase and nicorandil can effectively improve TIMI flow grades and heart function,relieve inflammatory response and prevent MACE occurrence in STEMI patients.

关键词

急性ST段抬高型心肌梗死/经皮冠状动脉介入治疗/瑞替普酶/尼可地尔

Key words

Acute ST-segment elevation myocardial infarction/Percutaneous coronary intervention/Reteplase/Nicorandil

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出版年

2024
中国循证心血管医学杂志
中国人民解放军北京军区总医院

中国循证心血管医学杂志

CSTPCD
影响因子：1.272
ISSN：1674-4055
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