郭丽霞,张兰,姜潇思,田立超,孙志军,陈韵岱,钱赓

• 1:北京联合大学校医院
• 2:军委政治工作部机关门诊部
• 3:中国人民解放军总医院心内科

摘要(Abstract)：

目的分析在非ST段抬高型急性冠状动脉综合征患者行经皮冠状动脉介入治疗(PCI术前使用尼可地尔预处理,从而减少PCI术中慢血流/无复流的总体效果。方法选自2017年1月至2017年12月在中国人民解放军总医院接受PCI术的非ST段抬高型急性冠状动脉综合征患者共1460例,随机分为尼可地尔干预组(728例)和对照组(732例)。其中尼可地尔干预组在术前使用尼可地尔预处理24 h,静脉滴注2 mg/h,在PCI术中观察患者支架置入术后冠状动脉血流灌注情况,评估靶血管开通后远端前向血流(TIMI血流分级),术后复查血生化结果并进行统计学分析,观察患者围术期并发症情况。结果入组患者平均年龄为(61.1±10.2)岁,男性76.1%(1111/1460),急性非ST段抬高型心肌梗死14.9%(217/1460)。两组患者心血管主要危险因素以及血生化指标比较,差异均无统计学意义(均P>0.05)。两组患者围术期使用规范的抗血小板药物和他汀类药物治疗比例比较,差异均无统计学意义(均P>0.05);两组在围术期使用β阻滞药、血管紧张素转换酶抑制药/血管紧张素Ⅱ受体拮抗药、钙通道阻滞药治疗比例比较,差异均无统计学意义(均P>0.05)。两组患者行冠状动脉支架置入术比例比较(97.9%比98.5%, P=0.437),差异无统计学意义。尼可地尔干预组患者术中无复流发生率(2.3%比4.4%,P=0.021)、围术期出现心肌损伤比例(5.9%比8.7%,P=0.024)比较,差异均有统计学意义。结论PCI术前使用尼可地尔预处理非ST段抬高型急性冠状动脉综合征患者可以有效预防术中无复流事件发生,有效保护心肌组织。

关键词(KeyWords)： 急性冠状动脉综合征;尼可地尔;无复流

Abstract:

Keywords:

基金项目(Foundation): “十三五”重大新药创制课题(2018ZX09201-013);; 心馨-默克心血管科研基金(2017-CCAxinxinmerck fund-003)

作者(Author): 郭丽霞,张兰,姜潇思,田立超,孙志军,陈韵岱,钱赓

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