目的:观察尼可地尔对急性呼吸窘迫综合征(ARDS)患者的心肌保护作用。方法:采用前瞻性随机对照研究方法,选择ARDS患者40例,随机分为治疗组(20例)和对照组(20例)。治疗组给予尼可地尔10 mg胃管注入3次/d,共5 d,余治疗两组相同。观察两组治疗前后超敏C反应蛋白(hs-CRP)、超敏心肌肌钙蛋白(hscTn)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及28 d病死率差异。结果:①两组患者性别、年龄、治疗前APACHEⅡ评分、hs-CRP及hs-cTn等基础状态无显著差异;②治疗后治疗组hs-CRP[11.35(3.63)g/L:13.50(5.93)g/L,P=0.027、hs-cTn[45.10(27.40)ng/L:65.70(74.58)ng/L,P=0.023较对照组明显降低;③治疗后两组APACHEⅡ评分[(21.05±8.58):(18.70±11.21)]及28 d死亡率(25%:15%)无统计学差异。结论:尼可地尔可减轻ARDS患者的心肌损害,保护心肌,但不能降低患者的28 d病死率。
Objective:To observe the effect of nicorandil on myocardium in patients with acute respiratory distress syndrome(ARDS).Method:A prospective controlled study was conducted.A total of 40 cases with ARDS were enrolled,and were randomly divided into treatment group(n=20) and control group(n = 20).The treatment group was given intragastric administration of nicorandil 10 mg,3 times/day,a total of 5 days.The rest of treatments were same in the two groups.The blood high-sensitivity C-reactive protein(hs-CRP) levels,the blood high-sensitivity cardiac troponin(hs-cTn) levels,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score and 28 day mortality were compared between two groups.Result:①There was no significantly difference in the basic state such as gender,age,hs-CRP[11.35(3.63)g/Lvs13.50(5.93) g/L,P = 0.027],hs-cTn[45.10(27.40) ng/L vs 65.70(74.58) ng/L,P = 0.023]and APACHE Ⅱ score between two groups.② After treatment,the blood hs-CRP and hs-cTn levels of treatment group were significantly lower than those in control group.?There was no significantly difference in APACHE Ⅱ score[(21.05±8.58) vs.(18.70±11.21)]and 28 day mortality(25%:15%) between the two groups after treatment.Conclusion;Nicorandil can reduce myocardial damage in patients with ARDS,but can not reduce the patient's 28 day mortality.