尼可地尔对糖尿病患者PCI术后心肌组织血流灌注及心肌细胞损伤的影响

摘要

目的:研究尼可地尔对糖尿病患者PCI术后心肌组织血流灌注及心肌细胞损伤的影响.方法:收集在本院接受PCI术治疗的冠心病合并2型糖尿病患者68例,根据单盲随机对照法分为观察组,对照组各34例.对照组接受单纯PCI术治疗,观察组在PCI术后接受尼可地尔治疗.治疗后,采用实时心肌超声造影评估两组的心肌血流灌注情况;采用血生化分析仪检测外周血心肌酶谱指标含量;采用ELISA法检测血清氧化应激指标含量;采用放射免疫法检测血清凋亡分子含量.结果:治疗后,观察组心肌组织血流灌注参数A、β、A×β的水平显著高于对照组(P<0.05);观察组外周血中心肌酶谱指标CK、LDH、cTnⅠ、GOT的含量显著低于对照组(P<0.05);观察组血清中VitE、VitC的含量显著高于对照组,MDA、AOPPs、sFas、sFasL含量低于对照组(P<0.05).结论:尼可地尔辅助治疗能够改善冠心病合并糖尿病患者PCI术后的心肌血流灌注、减轻心肌细胞损伤.%Objective: To study the effect of nicorandil on the myocardial tissue perfusion and myocardial cell damage in patients with diabetes after PCI.Methods: 68 patients with coronary heart disease and type 2 diabetes mellitus who received PCI in our hospital between May 2011 and September 2015 were collected and then divided into observation group and control group (n=34) according to the single-blind randomized control method.Control group of patients received PCI alone, and the observation group of patients received nicorandil therapy after PCI.After treatment, real-time myocardial ultrasound contrast was used to evaluate the myocardial perfusion of two groups of patients;blood biochemical analyzer was used to detect the contents of peripheral blood myocardial enzyme spectrum indexes;the ELISA method was used to detect the contents of serum oxidative stress indicators;RIA method was used to detect the contents of serum apoptosis molecules.Results: After treatment, the myocardial tissue perfusion parameters A, β and A×β levels of observation group were significantly higher than those of control group (P<0.05);peripheral blood myocardial enzyme spectrum indexes CK, LDH, cTnⅠ and GOT contents of observation group were significantly lower than those of control group (P<0.05);serum VitE and VitC contents of observation group were significantly higher than those of control group while MDA, AOPPs, sFas and sFasL contents were lower than those of control group (P<0.05).Conclusions: Adjuvant nicorandil therapy can improve the myocardial perfusion and reduce the myocardial cell injury in patients with coronary heart disease and diabetes mellitus after PCI.