尼可地尔对行PCI不稳定型心绞痛病人心肌保护作用

目的探讨口服尼可地尔对行经皮冠状动脉介入治疗（PCI）不稳定型心绞痛病人的心肌保护作用。方法以在我科住院需行PCI的不稳定型心绞痛病人60例作为研究对象,随机分为2组,各30例。对照组入院后给予不稳定型心绞痛常规治疗;尼可地尔组在常规治疗的基础上,术前48h给予尼可地尔每次5mg,每天3次,术后继续以相同剂量口服尼可地尔8周。比较两组PCI治疗前及治疗后6、12、24h血清肌酸激酶同工酶（CK-MB）、肌钙蛋白I（cTnI）水平;观察术后8周病人心电图及左心室射血分数改善情况。结果 PCI术后24h尼可地尔组血清CK-MB、cTnI水平显著低于对照组（t=2.040、2.241,P〈0.05）。PCI术后血清CK-MB、cTnI水平均高于正常值上限者尼可地尔组5例（16.7%）,对照组13例（43.3%）,差异有统计学意义（P=0.047）。PCI术后8周尼可地尔组心电图疗效和左心室射血分数明显优于对照组（u=2.475,t=2.061,P〈0.05）。结论口服尼可地尔对行PCI的不稳定型心绞痛病人有一定的心肌保护作用。

PROTECTIVE EFFECTS OF NICORANDIL ON PATIENTS WITH UNSTABLE ANGINA PECTORIS UNDERGOING PERCUTANE- OUS CORONARY INTERVENTION

Objective To observe the myocardial protective effect of oral Nicorandil on patients with unstable angina pec toris （UAP） undergoing percutaneous coronary intervention （PCI） therapy. Methods Sixty patients with UAP needed PCI were equally randomized to Nicorandil group and control group. The patients in control group were given a conventional therapy, those in Nicorandil group were added Nicorandil, 5 rag, three times a day, 48 hours prior to PCI, in addition to routine therapy. The medication was continued for eight weeks after PCI. Serum concentrations of creatine kinase-MB （CK-MB） and cardiac tropo nin I （cTnI） were measured in both of the groups before and 6, 12, and 24 h after PCI. The electrocardiogram （ECG） and left yen tricular ejection fraction （LVEF） were observed eight weeks after the procedure. Results The serum levels of CK-MB and cTnI were significantly lower in the Nicorandil group than that in the control group 24 h after PCI （t= 2. 040,2. 241;P〈0.05）. Post-PCI serum CK-MB and cTnI elevated were noted in five patients （16. 7%） in Nicorandil group and 13（43. 3%） in the control group, the difference being significant between the two groups （P=0. 047）. Follow-up ECG and echocardiography conducted eight weeks after PCI revealed that the ECG and LEVF improved better in Nicorandil group than the control （u= 2. 475,t= 2. 061;P〈0. 05）. Conclusion Oral administration of Nicorandil has a definite myocardial protection in patients with UAP undergoing PCI.