艾司洛尔联合尼可地尔对重度冠心病心肌缺血患者影响研究  

Effects of esmolol combined with nicorandil on myocardial ischemia in patients with severe coronary atherosclerotic heart disease

作　　者：林雪 孙海清[1] 姚俊秀[1] LIN Xue;SUN Hai-qing;YAO Jun-xiu(No.3 Cadre Ward,The General Hospital of Chengdu Military Command,Chengdu 610083,China)

机构地区：[1]成都军区总医院干部病房第三病区,四川成都610083

出　　处：《临床军医杂志》2018年第10期1147-1149,1152,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨艾司洛尔联合尼可地尔对重度冠心病心肌缺血患者的影响。方法选取自2017年1月至2018年1月成都军区总医院收治的130例重度冠心病心肌缺血患者为研究对象。将患者随机分为两组,每组65例:艾司洛尔组应用艾司洛尔进行治疗,联合组在艾司洛尔基础上联合应用尼可地尔。比较两组患者临床疗效、心电图、左室功能、血清生化指标及不良反应发生情况等。结果联合组有效率为95. 4%(62/65),高于艾司洛尔组的81. 5%(53/65),差异有统计学意义(P <0. 05)。治疗后,两组患者的心率、舒张压、收缩压均较治疗前下降,且联合组均低于艾司洛尔组,差异均有统计学意义(P <0. 05);两组患者的ST段压低次数、ST段压低持续时间、心肌缺血负荷均较治疗前下降,且联合组均低于艾司洛尔组,差异均有统计学意义(P <0. 05);两组患者的室间隔厚度、左室后壁舒张末期厚度、A峰均较治疗前下降,且联合组均低于艾司洛尔组,而两组患者的E峰、E/A均较治疗前升高,且联合组均高于艾司洛尔组,差异均有统计学意义(P <0. 05);两组患者的N端脑钠肽前体、丙二醛均较治疗前下降,且联合组均低于艾司洛尔组,而两组患者的超氧化物歧化酶较治疗前升高,且联合组高于艾司洛尔组,差异均有统计学意义(P <0. 05)。艾司洛尔组的不良反应发生率为15. 4%(10/65),高于联合组的4. 6%(3/65),差异有统计学意义(P <0. 05)。结论艾司洛尔联合尼可地尔可有效改善重度冠心病心肌缺血患者的左室舒张功能,降低氧化应激水平。Objective To investigate the effects of esmolol combined with nicorandil on myocardial ischemia in patients with severe coronary heart disease.Methods A retrospective study was performed on 130 cases of patients with myocardial ischemia of severe coronary heart disease who were admitted from January 2017 to January 2018.Patients were randomly divided into the esmolol group,patients were given esmolol,the others in the combined group were given esmolol combined with nicorandil.The clinical efficacy,electrocardiogram,left ventricular function,serum biochemical indexes and adverse reactions were compared between the two groups.Results The total effective rate was 81.5%(53/65).In the joint group,40 cases were effective,22 cases effective and 3 cases ineffective,and the total effective rate was 95.4%(62/65).The difference between the two groups was statistically significant(P<0.05).In the esmolol group,there were excellent in 35 cases,effective in 18 cases,ineffective in 12 cases,and the total effective rate was 81.5%(53/65).In the combined group,there were excellent in 40 cases,effective in 22 cases,ineffective in 3 cases,and the total effective rate was 95.4%(62/65),and the difference between the two groups was statistically significant(P<0.05).After treatment,the HR,DBP and SBP in the two groups were reduced compared with those before treatment,and the combined group was lower than the esmolol group,with statistically significant differences(P<0.05).ST segment depression times,ST segment depression duration,myocardial ischemia load in the observation group were significantly lower than those in the control group(P<0.05).IVSD,LVPWD and A peak were all reduced than those before treatment,and in the combined group was lower than the esmolol group;the E peak,E/A were all increased than those before treatment,and in the combined group was higher than the esmolol group,with statistically significant differences(P<0.05).The level of serum NT-proBNP and MDA in both groups was significantly lower,the level in the combined g

关 键 词：尼可地尔 艾司洛尔 冠心病 心肌缺血 

分 类 号：R541[医药卫生—心血管疾病]