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Application of Nicardipine Combined with rh-proUK in Percutaneous Coronary Intervention for Chronic Total Occlusion of Coronary Artery |
PU Mingyu, ZHENG Xi, HE Lin |
Beijing Anzhen Hospital, Capital Medical University / Nanchong Central Hospital, Sichcuan Nanchong 637000, China |
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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.
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[1] Moroni F,Brilakis ES,Azzalini L.Chronic total occlusion percutaneous coronary intervention:managing perforation complications[J].Expert Rev Cardiovasc Ther,2021,19(1):71-87. [2] Keulards DCJ,Vlaar PJ,Wijnbergen I,et al.Coronary physiology before and after chronic total occlusion treatment:what does it tell us[J].Neth Heart,2021,29(1):22-29. [3] Prasad M,Maehara A,Ahmad Y,et al.Intravascular ultrasound in chronic total occlusion percutaneous coronary intervention:solving ambiguity and improving durability[J].Interv Cardiol Clin,2021,10(1):75-85. [4] 孙洪伟,李伦,丰文俊,等.阿司匹林联合小剂量替罗非班预防冠心病PCI术后血栓形成的效果评价[J].中国实用医药,2023,18(2):108-110. [5] 王德良,王新华,裴建行,等.STEMI介入术中冠脉内不同部位应用重组人尿激酶原的疗效观察[J].河北医药,2021,43(2):231-234. [6] 王子超,刘静,张健民,等.冠状动脉腔内注入重组人尿激酶原对急性ST段抬高型心肌梗死患者的影响[J].中国中西医结合急救杂志,2021,28(3):302-306. [7] 马建飞,刘宪桂,赵靖华,等.芪苈强心胶囊联合尼可地尔对射血分数保留性心力衰竭患者心功能及细胞因子的影响[J].广东医学,2023,44(3):379-382. [8] 高海军,陈永,李培,等.香丹注射液联合尼可地尔治疗冠心病稳定型劳力性心绞痛的疗效[J].贵州医科大学学报,2023,48(8):986-992. [9] Gao J,Wang WJ,Liu YH,et al.Efficacy of half-dose recombinant human prourokinase thrombolysis combined with early PCI in 48 patients with ST-segment-elevation myocardial infarction (STEMI)[J].Asian Surg,2023,46(4):1658-1659. |
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