| 于盼盼,穆丽萍,王磊,等.尼可地尔联合依洛尤单抗对 STEMI行急诊 PCI病人左室功能及左室充盈压的影响[J].安徽医药,2025,29(12):2528-2533. |
| 尼可地尔联合依洛尤单抗对 STEMI行急诊 PCI病人左室功能及左室充盈压的影响 |
| Effect of combination therapy with nicorandil and elomumab on left ventricular function and left ventricular filling pressure in patients undergoing emergency PCI for STEMI |
| |
| DOI：10.3969/j.issn.1009-6469.2025.12.042 |
| 中文关键词: ST段抬高型心肌梗死 经皮冠状动脉介入治疗 左室充盈压 尼可地尔 依洛尤单抗 利钠肽，脑 肌钙蛋白 T |
| 英文关键词: ST segment elevation myocardial infarction Percutaneous coronary intervention treatment Left ventricular filling pres-sure Nicorandil Evolocumab Natriuretic peptide, brain Troponin T |
| 基金项目: |
|
| 摘要点击次数: 605 |
| 全文下载次数: 290 |
| 中文摘要: |
| 目的探讨在尼可地尔基础上联合依洛尤单抗对急性 ST段抬高型心肌梗死( STEMI)行急诊经皮冠状动脉介入治疗(PCI)病人左室功能及左室充盈压的影响。方法选取沧州市中心医院于 2023年 7月至 2024年 2月收治的 STEMI且行 PCI的住院病人 120例，依据随机数字表法分为单一组(60例)与合药组(60例)。单一组在术中和术后使用尼可地尔注射液和口服片，合药组在术中和术后使用依洛尤单抗注射液。采用三维彩色超声系统扫描并计算病人的二尖瓣舒张早期血流峰值速度与二尖瓣环舒张早期运动峰值速度比值( E/e')、左室收缩末期容积( LVESV)、左室舒张末期容积( LVEDV)、左室射血分数( LVEF)、左室质量指数( LVMI)。利用冠状动脉造影评价病人的心肌梗死溶栓治疗临床试验( TIMI)血流分级。利用心电图检查病人术后的 ST段抬高恢复情况(STR)。利用 ELISA试剂盒检测血清中的 N末端 B型利钠肽(NT-proBNP)、心肌肌钙蛋白 T(cTnT)、超敏 C反应蛋白( hs-CRP)。记录病人术后的出血情况和主要不良心血管事件( MACE)。结果治疗后，合药组与单一组的超声指标有所改善，合药组的 E/e'(9.17±1.65比 10.39±2.04)LVESV［(60.66±6.28)mL比( 67.84±6.89)mL］、 LVEDV［(117.29±12.34)mL比(125.68±12.75)mL］、 LVMI［(78.33±9.05)g/m2比( 823±9.37)g/m2］低于单一组， LVEF［(50.07±5.49)%比( 45.73±4.82)%］高于单一组( P<0.05)。 PCI术后，合药组的 TIMI血流分级优于单一组(P<0.05)。治疗后，合药组的 NT-proBNP［(222.65±24.16)ng/L比.9、(262.74±27.92)ng/L］、 cTnT［(151.87±18.08)ng/L比( 194.37±20.62)ng/L］、 hs-CRP［(176.43±27.49)ng/L比( 212.80±33.27)ng/L］低于单一组( P<0.05)合药组的 STR≥70%的比例高于单一组( P<0.05)。结论依洛尤单抗联合尼可地尔可改善 STEMI行急诊 PCI病人梗死血管回流和左室功能，降低左室充盈压和血清 NT-proBNP、cTnT、hs-CRP水平，显著恢复病人 ST段抬高情况。 |
| 英文摘要: |
| Objective To investigate the effect of nicorandil combined with evolocumab on left ventricular function and left ventricu-lar filling pressure in patients undergoing emergency percutaneous coronary intervention (PCI) for acute ST segment elevation myocardi-al infarction (STEMI).Methods A total of 120 hospitalized patients with STEMI who underwent PCI and were admitted to CangzhouCentral Hospital from July 2023 to February 2024 were selected. They were randomly separated into a single group (60 cases) and acombination group (60 cases) according to the random number table method. The single group was treated with nicorandil injection andoral tablets during and after surgery, while the combination group was treated with evolocumab injection during and after surgery. Thethree-dimensional color ultrasound system was applied to scan and calculate the ratio of early diastolic blood flow peak velocity of themitral valve to early diastolic peak velocity of the mitral annulus (E/e'), left ventricular end systolic volume (LVESV), left ventricularend diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), and left ventricular mass index (LVMI) of patients. Coronaryangiography was used to evaluate the thrombolysis in myocardial infarction (TIMI) blood flow grading of patients. Electrocardiogramwas used to examine the recovery of ST segment elevation (STR) in patients after surgery. ELISA kit was applied to detect N-terminal B-type natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), and hypersensitive C-reactive protein (hs-CRP) in serum. The postop-erative blood loss and major adverse cardiovascular events (MACE) were recorded.Results After treatment, the ultrasound index of the combination group and the single group improved. The E/e' (9.17±1.65 vs. 10.39±2.04), LVESV[(60.66± 6.28) mL vs. (67.84±6.89) mL], LVEDV [(117.29±12.34) mL vs. (125.68±12.75) mL] and LVMI [(78.33±9.05) g/m2 vs. (82.93±9.37) g/m2] of the combination group were lower than those of the single group, while LVEF [(50.07±5.49) % vs. (45.73±4.82) %] were higher than those of the single group (P<0.05). After PCI, the TIMI blood flow grading in the combination group was better than that in the single group (P<0.05). Af-ter treatment, the NT-proBNP [(222.65±24.16) ng/L vs. (262.74±27.92) ng/L], cTnT [(151.87±18.08) ng/L vs. (194.37±20.62) ng/L], and hs-CRP [(176.43±27.49) ng/L vs. (212.80±33.27) ng/L] in the combination group were lower than those in the single group (P<0.05). The proportion of STR ≥ 70% in the combination group was higher than that in the single group (P<0.05).Conclusion The combina-tion of evolocumab and nicorandil can improve infarct vascular reflux and left ventricular function in STEMI patients undergoing emer-gency PCI, reduce left ventricular filling pressure and serum NT-proBNP, cTnT, hs-CRP levels, and significantly resolve ST segment el-evation. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
