尼可地尔与地尔硫卓治疗经皮冠状动脉介入治疗术后再发不稳定型心绞痛疗效分析
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(1. 解放军第25;2.医院心内科,保定 071000 ;2. 保定市第一中医院急诊科,保定 071000)

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R541.4

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Clinical efficacy of nicorandil versus diltiazem for recurrent unstable angina pectoris after percutaneous coronary intervention
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(1. Department of Cardiology, Chinese PLA Hospital No. 252, Baoding 071000, China;2. Emergency Department, Baoding First Hospital of Traditional Chinese Medicine, Baoding 071000, China)

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    摘要:

    目的 研究尼可地尔和地尔硫卓对经皮冠状动脉介入(PCI)术后再发不稳定型心绞痛(UAP)患者的临床疗效。方法 入选2015年1月至2016年8月解放军第252医院PCI术后再发UAP患者72例,随机数字表法分为尼可地尔组和地尔硫卓组,每组36例。尼可地尔组患者男性24例,女性12例,年龄48~80(62.61±9.26)岁,常规治疗基础上加服尼可地尔片5 mg,口服,3次/d 。地尔硫卓组患者男性21例,女性15 例,年龄48~79(61.72±8.18)岁,常规治疗基础上加服地尔硫卓90 mg,口服,2次/d,比较两组患者服药60 d期间每周心绞痛发作次数及持续时间、硝酸甘油服用量、心电图改变及不良反应情况。结果 两组患者的年龄、性别、病程、吸烟史、SYNTAX评分、合并疾病差异无统计学意义(P>0.05)。相比服药前,服药后两组患者每周心绞痛发作次数、持续时间、硝酸甘油服用量均有所减少,且尼可地尔组明显优于地尔硫卓组,差异有统计学意义(P<0.05)。尼可地尔组患者服药有效率88.9%(32/36),地尔硫卓组患者服药有效率75.0%(27/36),两组有效率差异无统计学意义(χ2=2.347,P=0.126)。相比尼可地尔,地尔硫卓易使患者出现头痛,差异有统计学意义(P<0.05)。结论 尼可地尔与地尔硫卓均对PCI术后再发UAP有疗效,尼可地尔的临床疗效显著,可明显改善心绞痛症状,并且不良反应少。

    Abstract:

    Objective To investigate the clinical efficacy of nicorandil and diltiazem in the recurrence of unstable angina pectoris (UAP) patients following postoperative percutaneous coronary intervention (PCI). Methods A total of 72 UAP patients who underwent PCI due to coronary heart disease in our hospital from January 2015 to August 2016 were enrolled in this study. They were randomly and equally divided into nicorandil (24 males and 12 females, at an age of 62.61±9.26 years, ranging from 48 to 80) and diltiazem groups (21 males and 15 females, at an age of 61.72±8.18 years, ranging from 48 to 79). The patients of the former group were given oral administration of 5 mg nicorandil, 3 times per day besides routine treatment, and those from the latter group received oral administration of 90 mg diltiazem, twice per day. During 60 days’ treatments, the frequency and duration of angina, nitroglycerin dosage, electrocardiographic changes, and adverse reactions every week were observed and compared between the 2 groups. ResultsThere were no significant differences in the age, gender, duration of disease, smoking history, comorbidity and score of Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) between the 2 groups (P>0.05). After 60 days’ treatment, the frequency and duration of weekly angina attack and nitroglycerin dosage were reduced, and the nicorandil group had obviously better outcomes than the diltiazem group (P<0.05). The total effective rate was 88.9%(32/36) in the nicorandil group, and 75.0%(27/36) in the diltiazem group, with no statistical difference between them (Chi square=2.347, P=0.126). Compared with the patients of nicorandil group, those of the diltiazem group were prone to headache (P<0.05). ConclusionNicorandil and diltiazem have curative efficacy in postoperative recurrence of UAP after PCI. Nicorandil is more significant in the treatment, with obvious improvement of angina symptoms and less adverse reactions.

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马永娜,张君实.尼可地尔与地尔硫卓治疗经皮冠状动脉介入治疗术后再发不稳定型心绞痛疗效分析[J].中华老年多器官疾病杂志,2017,16(6):414~417

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  • 收稿日期:2016-12-09
  • 最后修改日期:2017-01-14
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  • 在线发布日期: 2017-06-27
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