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尼可地尔对择期经皮冠状动脉介入治疗的冠心病患者的心脏保护作用。

Cardioprotective Effects of Nicorandil on Coronary Heart Disease Patients Undergoing Elective Percutaneous Coronary Intervention.

作者信息

Pang Zhihua, Zhao Wei, Yao Zhuhua

机构信息

Department of Cardiology, Tianjin Union Medical Center, Tianjin, China (mainland).

Heyuan Community Health Service Centers of Hongqiao District, Tianjin, China (mainland).

出版信息

Med Sci Monit. 2017 Jun 15;23:2924-2930. doi: 10.12659/msm.902324.

DOI:10.12659/msm.902324
PMID:28617765
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5484606/
Abstract

BACKGROUND Nicorandil is a nicotinamide ester commonly prescribed for treatment of patients with coronary heart disease (CHD). In the present study, we aimed to explore the cardioprotective effects of nicorandil on CHD patients undergoing elective percutaneous coronary intervention (PCI). MATERIAL AND METHODS One hundred patients with CHD undergoing PCI were randomly divided into a control group (n=48) and a nicorandil group (n=52). Patients in the control group received traditional therapy, and while patients in the nicorandil group received nicorandil before PCI in addition to the traditional therapy. After PCI, all patients underwent coronary angiogram, and TIMI frame count (TFC) was calculated. Plasma levels of cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), myeloperoxidase (MPO), and malondialdehyde (MDA) were determined before and at 6, 18, and 24 h after PCI. Moreover, systolic blood pressure (SBP), mean blood pressure (DBP), heart rate (HR), and left ventricular ejection fractions (LVEF) were recorded before and 3 months after PCI. RESULTS There was a significant difference in the rate of no-reflow (P=0.036) between the 2 groups. The blood frames and levels of cTnI, CK-MB, MPO, and MDA in the nicorandil group were significantly decreased compared to the control group (all P<0.05). Moreover, administration of nicorandil markedly decreased SBP, MBP, and HR, but obviously increased LVEF at 3 months after PCI (P<0.05 or P<0.01). CONCLUSIONS Nicorandil exerts cardioprotective effects on CHD patients undergoing elective PCI by decreasing PCI-related myocardial injury and rate of no-reflow and improvement of LVEF.

摘要

背景

尼可地尔是一种常用于治疗冠心病(CHD)患者的烟酰胺酯。在本研究中,我们旨在探讨尼可地尔对接受择期经皮冠状动脉介入治疗(PCI)的冠心病患者的心脏保护作用。

材料与方法

100例接受PCI的冠心病患者被随机分为对照组(n = 48)和尼可地尔组(n = 52)。对照组患者接受传统治疗,而尼可地尔组患者除传统治疗外,在PCI前接受尼可地尔治疗。PCI后,所有患者均接受冠状动脉造影,并计算心肌梗死溶栓治疗(TIMI)帧数(TFC)。在PCI前以及PCI后6、18和24小时测定血浆心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)、髓过氧化物酶(MPO)和丙二醛(MDA)水平。此外,记录PCI前和PCI后3个月的收缩压(SBP)、平均血压(DBP)、心率(HR)和左心室射血分数(LVEF)。

结果

两组间无复流发生率有显著差异(P = 0.036)。与对照组相比,尼可地尔组的血帧数以及cTnI、CK-MB、MPO和MDA水平显著降低(均P < 0.05)。此外,尼可地尔给药显著降低了SBP、MBP和HR,但在PCI后3个月明显增加了LVEF(P < 0.05或P < 0.01)。

结论

尼可地尔通过减少PCI相关的心肌损伤和无复流发生率以及改善LVEF,对接受择期PCI的冠心病患者发挥心脏保护作用。

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