摘要
目的:探讨经皮冠状动脉介入治疗(PCI)术中心肌复流与预后的关系及尼克地尓的保护作用。方法:选择于本院行PCI术的患者150例,根据PCI术前治疗方法不同分为对照组(阿司匹林100mg+阿托伐他汀20mg+氯吡格雷300mg)和观察组(阿司匹林100mg+阿托伐他汀20mg+氯吡格雷300mg+尼克地尔10mg)各75人,两组术后使用低分子肝素4 100IU3天,阿司匹林100mg+阿托伐他汀20mg+氯吡格雷75mg。采集患者术前1h、术后即刻、术后1、6、12、24h血液标本5mL检测肌钙蛋白I(TnI)和心肌酶谱(CK、CK-MB等)水平,评价心肌无复流及再灌注心肌损伤情况;患者术前1h、术后即刻、术后2、12、24h心电图,观察ST段抬高指数,评价微血管再灌注情况;术后随访6个月评价尼克地尔减少PCI术中无复流对患者预后改善情况。结果:两组术后1、6、12、24hTnI、Mb、CK-MB水平比较,差异均具有统计学意义(P<0.05);各时点TnI、Mb、CK-MB水平均高于对照组且无交互作用。对照组术后即刻、术后2、12、24h心电图ST段抬高指数与观察组比较,差异均具有统计学意义(P<0.05);对照组各时点ST段抬高幅度高于观察组且无交互作用。术后随访6个月,对照组复合终点事件发生率高于观察组,差异具有统计学意义(P<0.05);两组SAQ和SF-36评分比较,差异具有统计学意义(P<0.05)。结论:尼克地尔对PCI术中心肌无复流情况少及再灌注心肌损伤具有保护作用,患者预后良好,值得临床推广使用。
Objective： To study the protection effects of Sigmart for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery. Methods： A total of 150 patients undergoing PCI surgery were selected and divided into control group and observation group with 75 cases in each group. The control group was given 100 mg aspirin ＋ 20 mg atorv- astatin ＋ 300 mg clopidogrel） and observation group was given （100 mg aspirin atorvastatin 20 mg ＋ clopidogrel 300 mg ＋ Sigmart 10 rag）. After undergoing the surgery, both groups were given low molecular heparin 4 100 IU for 3 days, 100 mg＋ aspirin＋atorvastatin 20 mg ＋ clopidogrel 75 mg. At different time points including before undergoing the surgery, the mo-ment right after the surgery, 1, 6, 12, 24 hours after undergoing the surgery, 5 mL of blood specimen were collected for de- tection of troponin I （TnI）, myocardial enzyme spectrum （CK, CK - MB） level to evaluate myocardial myocardial reperfusion injury after undergoing PCI surgery. Also electrocardiogram （ECG） were detected the moment right after the surgery, 2, 12, 24 hours after undergoing the surgery to evaluate the myocardial status. Six months after the surgery, effects of Sigmart for tack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery were evaluated. Results： 1, 6, 12, 24 h after the surgery, TnI, Mb, CK - Mb levels of were significant different from those before undergoing the surgery （P~ 0.05）, and these levels of the observation group were significant higher than that of the control group （P%0.05）. ST segment elevation at 2, 12, and 24 hours after undergoing the surgery were significant obvious than that of the control group. According to the follow up, incidence of comprehensive＇end point event was significant higher than that of the control group. SAQ and SF - 36 scores of the two groups were significant different （P〈 0.05）. Conclusion： Sigmart shows good protection effects for lack of reflow or myocardial myocardial reperfusion injury after undergoing PCI surgery.
出处
《海南医学院学报》
CAS
2015年第8期1045-1047,1050,共4页
Journal of Hainan Medical University
基金
陕西省科技攻关计划项目(2014K11-03-01-05)~~
