尼可地尔对急性ST段抬高性心肌梗死再灌注疗效的研究进展
Research progress of nicorandil on reperfusion effect of acute ST segment elevation myocardial infarction
摘要尼可地尔是一种新型的血管扩张剂,具有类硝酸酯和三磷酸腺苷敏感性钾(KATP)通道开放的双重作用。冠状动脉内注射尼可地尔可扩张冠状动脉,保护冠状动脉微循环,通过作用于多种信号通路起到抗炎作用,抑制微血栓形成,增加心肌灌注,降低无复流的发生率;还可缩小梗死面积,改善心脏功能;还可通过多种细胞膜酶信号通路,使细胞内流出的钾离子明显增加,引起细胞膜超极化,并抑制钙离子向细胞内流动,抑制细胞内钙超载,降低再灌注心律失常的发生,减轻再灌注损伤。因此,其对急性心肌梗死患者有良好的心肌保护作用。
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abstractsNicorandil is a new vasodilator, which has the dual effects of nitrate like ester and ATP sensitive potassium channel (KATP channel) opening. Intracoronary injection of nicorandil can expand the coronary artery, protect the coronary microcirculation, and play an anti-inflammatory role, inhibit microthrombosis, increase myocardial perfusion and reduce the incidence of no reflow by acting on a variety of signal pathways; It can also reduce the infarct area and improve cardiac function; Through a variety of cell membrane enzyme signal pathways, it can significantly increase the outflow of potassium ions in cells, cause cell membrane hyperpolarization, inhibit the flow of calcium ions into cells and intracellular calcium overload, reduce the occurrence of abnormal reperfusion rhythm and reperfusion injury. Therefore, it has a good myocardial protective effect on patients with acute myocardial infarction.
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