血栓抽吸联合冠脉内给予尼可地尔对急性心肌梗死急诊PCI术后无复流的影响

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摘要目的探讨血栓抽吸联合冠脉内给予尼可地尔对急性心肌梗死急诊PCI无复流的影响与安全性。方法选取2014年12月～2015年12月我院收治的IRA术前TIMI≤1级的120例急性ST段抬高心肌梗死行急诊PCI患者，按病历号随机分为观察组和对照组，各60例，两组手术方法相同，出现无复流现象后分别经冠脉给予尼可地尔和硝酸甘油。比较两组注射药物后TIMI血流分级、TMPG分级、心电图ST段回落、住院期间的主要心血管事件。结果观察组TIMI血流分级、TMPG分级优于对照组，差异有统计学意义(P＜0.05)。观察组心电图ST段回落率高于对照组，差异有统计学意义(P＜0.05)。观察组住院期间的主要不良心血管事件（MACE）发生率低于对照组，差异有统计学意义(P＜0.05)。结论AMI行急诊PCI血栓抽吸联合冠脉内给予尼可地尔可改善冠脉血流和梗死区的心肌再灌注，改善近期预后，安全有效。

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关键词 ：急性心肌梗死, 经皮冠脉介入治疗, 血栓抽吸, 尼可地尔

Abstract：Objective To investigate the effect and security of thrombus aspiration associated with Nicorandil in coronary on no-reflow of acute myocardial infarction after emergency percutaneous coronary intervention(PCI).Methods 120 patients in our hospital from December 2014 to December 2015,with emergency PCI for ST elevation myocardial infarction,preoperative infarction related artery(IRA)thrombolysis in myocardial infarction(TIMI)≤grade 1,were randomly divided into nicorandil group and control group according to the medical record number,each group had 60 patients.Two group did the same operation.When no-reflow after PCI appeared,intracoronary Nicorandil or Nitroglycerin was administered in each group separately.At the end of PCI,TIMI grade and TIMI myocardial perfusion grade(TMPG) were observed in the two groups,ST-segment down of ECG and the incidence of major adverse cardiac events(MACE)during hospitalization were compared between two groups.Results The proportion of with TIMI grade and TMPG grade of the nicorandil group was significantly better than that of the control group(P＜0.05).The incidence rate of ST-segment down of the nicorandil group was significantly higher than that of the control group(P＜0.05).The incidence rate of MACE in the nicorandil group was significantly lower than that in the control group before discharge(P＜0.05).Conclusion The therapy of thrombus aspiration associated with Nicorandil in coronary for no-reflow of acute myocardial infarction after emergency PCI can improve coronary blood flow and myocardial reperfusion in infarct area,improve shortterm prognosis and is safe and effective.

Key words： Acute myocardial infarction Percutaneous coronary intervention Thrombus aspiration Nicorandil

基金资助:北京力生心血管健康基金会领航基金（LHJJ2014 2511）

作者简介: 邓根群（1966-），男，硕士，主任医师，研究方向：冠心病介入治疗

引用本文:

吴君;邓根群. 血栓抽吸联合冠脉内给予尼可地尔对急性心肌梗死急诊PCI术后无复流的影响[J]. 中国当代医药, 2017, 24(7): 60-63.
WU Jun;DENG GEN-qun. Effects of thrombus aspiration associated with Nicorandil in coronary on no-reflow of acute myocardial infarction after emergency PCI. 中国当代医药, 2017, 24(7): 60-63.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I7/60

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