| Objective: Analysis of the effects of different vasodilators on coronary blood flow in patients with NSTE-ACS during perioperative PCI Methods:A total of 61 patients with NSTE-ACS who underwent elective PCI in the Department of Cardiology of the First Affiliated Hospital of China Medical University from December 2017 to December 2019 were selected.According to the different perioperative medications,it was divided into group A with 31 cases and intravenous application of isoket not less than 20 mg / d;group B with 30 cases with nicorandil not less than 24 mg / d,all of which were applied at least 12-24 hours before surgery.Collect general clinical data,biochemical test indicators,cardiac function indicators and other data of patients.Coronary angiography was completed on a selective basis,and the corrected TIMI frames of the target lesion vessels before surgery were measured in all patients.Both A and B groups were injected with 2 mg of isoket in the coronary arteries before PCI,and coronary angiography was performed again one minute later to measure the number of corrected TIMI frames before and after treatment and the minimum lumen diameter of the target lesion before and after treatment.Relevant data were analyzed by rank sum test,chi-square test,independent sample t test,and other methods.P <0.05 is statistically significant.Results: 1.Comparison of general clinical data of group A with group B,a total of 61 patients with NSTE-ACS who underwent elective PCI were aged 64(58-68)years old,including 40 males,accounting for 65.5% of the total,44 patients with unstable angina(72.1%),and acute non-ST-segment elevation 17 cases of myocardial infarction(27.9%),there were no significant differences in general clinical data,general biochemical indexes,cardiac function indexes,etc.between the two groups(P>0.05)2.Comparison of autologous blood flow after intracoronary injection of isoket in group A1 and group B1,the number of target lesions after treatment was 20(16-26)frames lower than 24(20-29)before treatment,the difference was statistically significant,c 2=-2.48,P=0.013;target lesions after treatment The smallest lumen diameter at 1.35(1.11-1.59)mm was dilated compared to 1.2(0.94-1.41)mm before administration,and the difference was statistically significant.c2=-3.09,P=0.002.3.Comparison of the number of target lesions in the A group and the B group before and after the administration of isoket in patients with coronary arteries,.The number of postoperative target lesion frames in both groups was 20(12-22)frames in group B lower than 22(16-26)frames in group A.There was a statistical difference between the two groups,c2 =-1.98,P = 0.048;There was no significant difference in the number of target lesion frames between the two groups of patients receiving isoket in coronary artery before and after treatment(P> 0.05).4.Comparison of the incidence of in-hospital MACEs between group A and group B,there was no statistical difference between the incidence of in-hospital MACEs between the two groups.5.Preoperative and postoperative target lesion blood flow were used as dependent variables for regression analysis.Age,gender,smoking,drinking,hypertension,diabetes,dyslipidemia,UA / NSTEMI,Hs-CRP,medication grouping and other factors were not statistically significanc Conclusion: 1.The effect of preoperative intravenous isoket on the blood flow of target lesions before PCI in patients with NSTE-ACS has no significant difference compared with intravenous nicorandil.2.Intracoronary injection of isoket may accelerate the blood flow velocity of target lesions and expand the smallest lumen diameter in stenosis.3.Preoperative use of nicorandil in combination with isoket in coronary arteries compared with isoket in venous and coronary arteries,the former improves blood flow after PCI in patients with NSTE-ACS. |
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