目的:研究尼可地尔对PCI术中慢复流患者术后心肌损伤、血小板功能及炎症反应程度的影响.方法:选择自贡市第四人民医院2015年3月～2017年8月期间进行急诊PCI且术中发生慢复流的病例,对病史资料进行回顾性分析并根据发生无复流后是否使用尼可地尔分为尼可地尔组和常规对照组.PCI术前及术后1天、术后3天时,测定血清中心肌损伤指标的含量及外周血中血小板活化分子、炎症信号分子的表达量.结果:与组内PCI术前相应指标比较,两组患者术后1天、术后3天时血清中 H-FABP 、HIF-1α 、CK-MB 、cTnI的含量以及外周血中PAR1 、PAR4 、CCR2 、p38MAPK 、HSP27 、Notch1 、NF-κB 、MEK1 、ERK1/2 、CaMKII的mRNA表达量均显著降低且尼可地尔组患者术后1天、术后3天时血清中 H-FABP 、HIF-1α 、CK-MB 、cTnI 的含量以及外周血中 PAR1 、PAR4 、CCR2 、p38MAPK 、HSP27 、Notch1 、NF-κB 、MEK1 、ERK1/2 、CaMKII的mRNA表达量均显著低于常规对照组.结论:尼可地尔对PCI术中慢复流患者术后心肌损伤、血小板活化及炎症反应激活均具有负性调节作用.%Objective :To study the effect of nicorandil on postoperative myocardial injury ,platelet function and inflam-matory response in patients with slow reflow in PCI .Methods :Patients who underwent emergency PCI and had intraoperative slow reflow in Zigong Fourth People’s Hospital between March 2015 and August 2017 were selected and divided into nicorandil group and normal control group according to the application of nicorandil after no reflow or not in the history data .The levels of myocardial injury indexes in serum as well as the expression of platelet activation molecules and inflammatory signaling mole-cules in peripheral blood were measured before PCI as well as 1 d and 3 d after PCI .Results :Compared with the corresponding indexes of same group before PCI ,serum H-FABP , HIF-1α ,CK-MB and cTnI levels as well as peripheral blood PAR1 , PAR4 ,CCR2 ,p38MAPK ,HSP27 ,Notch1 ,NF-κB ,MEK1 ,ERK1/2 and CaMKII mRNA expression of both groups of pa-tients were significantly lower 1 d and 3 d after PCI ,and serum H-FABP ,HIF-1α ,CK-MB and cTnI levels as well as periph-eral blood PAR1 ,PAR4 ,CCR2 ,p38MAPK ,HSP27 ,Notch1 ,NF-κB ,MEK1 ,ERK1/2 and CaMKII mRNA expression of nicorandil group 1 d and 3 d after PCI were significantly lower than those of normal control group .Conclusion :Nicorandil has negative regulating effect on postoperative myocardial injury ,platelet activation and inflammatory response activation in pa-tients with slow reflow in PCI .
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