盐酸地尔硫和硝酸甘油联合治疗不稳定型心绞痛的效果  

Clinical analysis of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris

作　　者：柳青 李慧芳[2] 刘丽凤[1] 董瓅瑾[3] 

机构地区：[1]武警山西总队医院药剂科,太原030006 [2]武警山西总队医院心内科,太原030006 [3]武警后勤学院,天津300162

出　　处：《武警医学》2012年第8期671-673,677,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的观察注射用盐酸地尔硫和硝酸甘油联合治疗不稳定型心绞痛的临床疗效。方法选择我院住院的101例不稳定型心绞痛患者,随机分为实验组(n=51)和对照组(n=50),对照组单用硝酸甘油,实验组应用硝酸甘油和盐酸地尔硫联合治疗。观察并比较两组患者用药48 h对心绞痛发作次数、心率、PR间期、QRS时限、QT间期、血压、心肌耗氧指标、血常规、血生化等指标。结果两组均无并发症,无死亡,并且血流动力学的改变及心律失常的发生率差别均无统计学意义。实验组治疗后心率及心肌耗氧指标(率压积)较对照组明显降低(P<0.05)。实验组PR间期和QT间期稍长于对照组,但差异无统计学意义。结论注射用盐酸地尔硫卓联合硝酸甘油治疗不稳定性心绞痛患者无明显不良反应,能有效缓解心绞痛,并能显著降低心肌氧耗,提供更佳的心肌保护。Objective To observe the efficacy of injection of diltiazem hydrochloride combined with nitroglycerin in the treat- ment of unstable angina pectoris. Methods 101 patients with unstable angina pectoris in our hospital were randomly divided into test group （n =51） and control group （n = 50）. The test group was administered with diltiazem hydrochloride in combination with nitro- glycerin while the control group was given nitroglycerin alone. After 48 hours, the two groups of patients were observed and compared in terms of anginal attacks, heart rate, PR, QRS, QT interval time, blood pressure, myocardial oxygen consumption index, blood rou- tiMe, blood biochemical index. Results There was no death, no complications or significant arrilythmias and hemodynamic changes. After treatment, the heart rate and myocardial oxygen consumption index of the test group decreased more significantly （ P 〈 0.05 ） than in the control group. PR interval and QT interval of the test group were slightly longer than those of the control group, but without sig- nificant difference. Conclusion Injection of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris patients induces no serious adverse reactions and can effectively relieve angina, significantly reduce myocardial oxygen con- sumption and provide better myocardial protection.

关 键 词：注射用盐酸地尔硫 硝酸甘油 不稳定型心绞痛 

分 类 号：R542.2[医药卫生—心血管疾病]