Abstract：Objective: To investigate the effect of targeted intracoronary injection of nicardipine combined with recombinant human pro-urokinase (rh-proUK) on the treatment of chronic total occlusion (CTO) of coronary artery and its impact on long-term prognosis. Methods: A total of 237 cases of CTO patients who underwent PCI in our hospital from September 2021 to January 2023 were collected as the study objects and a retrospective study was carried out. Patients treated with nicodil combined with PCI through targeted catheter were included in Nicodil group (n=78), and patients treated with rh-proUK combined with PCI through a targeted catheter were included in the rh-proUK group (n=78). Patients treated with nicodil and rh-proUK combined PCI via targeted catheter were included in the combination group (n=81). The microcirculation indexes [TIMI blood flow grading, corrected TIMI blood flow frame count (cTFC), TIMI myocardial perfusion grading (TMPG)], myocardial injury indexes [creatinine, N-terminal brain natriuretic peptide precursor (NT-proBNP), creatine kinase isoenzyme (CK-MB), and troponin (IcTnI)], cardiac function [left ventricular ejection fraction (LVEF), ventricular wall motion integral index (WMSI), left ventricular end-diastolic inner diameter (LVED)], myocardial microcirculation blood perfusion [myocardial perfusion quantitative analysis constant (k)], and incidence of adverse cardiovascular events were compared between the three groups. Results: The proportion of TMPG grade 3 in the combination group was higher than that in the Nicodil group and rh-proUK group, and cTFC was lower than that in the Nicodil group and rh-proUK group (P<0.05). 24h after the operation, CK-MB, creatinine, IcTnI and NT-proBNP in the combination group were lower than those in nicodil and rh-proUK groups (P<0.05). Three months after the operation, LVEF in the combination group was higher than that in nicodil group and rh-proUK group, and LVED was lower than that in nicodil group and rh-proUK group (P<0.05). The k value of myocardial microcirculation perfusion in basal state and load state in the combination group was higher than that in the nicodil group and rh-proUK group (P<0.05). There was no significant difference in the total incidence of adverse cardiovascular events at 6 months and 12 months after surgery among 3 groups (P>0.05). Conclusion: Targeted catheter injection of nicodil and rh-proUK combined PCI in the treatment of CTO patients can promote postoperative myocardial microcirculation improvement, help alleviate postoperative myocardial injury, restore cardiac function, reduce adverse cardiovascular events, and improve long-term prognosis.
蒲明玉, 郑曦, 何蔺. 尼可地尔与rh-proUK联合PCI术在冠状动脉慢性完全闭塞中的应用[J]. 河北医学, 2024, 30(7): 1222-1228.
PU Mingyu, ZHENG Xi, HE Lin. Application of Nicardipine Combined with rh-proUK in Percutaneous Coronary Intervention for Chronic Total Occlusion of Coronary Artery. HeBei Med, 2024, 30(7): 1222-1228.
2024, Vol. 30 
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