羟考酮缓释剂对ST 段抬高心肌梗死患者 急诊PCI 治疗近期预后的影响

Effect of oxycodone prolonged-release tablets on the short-term prognosis in patients with acute ST-segment elevation myoardial infarction undergoing primary percutaneous coronary intervention

摘要:

目的 探讨羟考酮缓释剂对ST 段抬高心肌梗死（STEMI）患者行急诊经皮冠状动脉介入术 （PCI）术后近期预后的影响。方法 选取2018 年3 月—2018 年9 月于河北大学附属医院诊断为STEMI 患 者102 例，将患者按随机数字表法分为羟考酮组和对照组。给予两组患者阿司匹林300 mg 口服、替格瑞 洛180 mg 嚼服及阿托伐他汀20 mg 口服治疗基础上，羟考酮组术前30 min 内给予盐酸羟考酮缓释片10 mg 口服，对照组给予安慰剂。然后行急诊PCI。比较两组患者基线资料、手术前及术后30 d 心功能指标及 PCI 术后30 d 主要不良心血管事件等，评估羟考酮缓释片对STEMI 急诊PCI 近期预后的影响。结果 羟 考酮组氨基末端脑钠肽前体、左心室舒张末期内径低于对照组（P <0.05），而左心室射血分数高于对照组 （P <0.05）。羟考酮组的支架内血栓、心力衰竭、二次手术及主要不良心血管事件发生率低于对照组（P <0.05）。 结论 应用羟考酮缓释片可改善STEMI 行急性PCI 患者术后30 d 的心功能，降低主要不良心血管事件发 生率。

Abstract:

Objective To investigate the effects of oxycodone prolonged-release tablets on the short-term prognosis in patients with acute ST-segment elevation myocardial infarction udergoing primary percutaneous coronary intervention. Methods Totally, one hundred and two patients with acute ST-segment elevation myocardial infarction were included into this study. Patients were randomly divided into oxycodone group and control group, with 51 cases in each group. Besides the routine loading dose of dual antiplatelet drugs (aspirin 300 mg, ticagrelor 180 mg) and atorvastatin (20 mg), patients in the oxycodone group were given oxycodone hydrochloride prolonged--release tablets 10 mg orally within 30 minutes before operation, and the control group was given placebo accordingly. Then, primary PCI was performed. The baseline data of the two groups, the cardiac function index before and after the procedure, and the major adverse cardiovascular events in one month after PCI was collected to evaluate the effects of oxycodone prolonged-release tablets on the short-term prognosis in these patients. Results The level of NT-pro BNP and left ventricular end-diastolic diameter in the oxycodone group were lower and left ventricular ejection fraction was higher than in the control group 30 days after the procedure (P < 0.05). The incidence of stent thrombosis, heart failure, secondary operation and major adverse cardiovascular events in oxycodone group was lower than that in the control group (P < 0.05). Conclusions Application of oxycodone prolonged-release tablets can improve cardiac function and reduce the incidence of adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction 30 days after primary percutaneous coronary intervention.