尼可地尔对老年冠心病稳定型心绞痛合并糖尿病患者的临床观察  

Clinical observation of Nicorandil in elderly patients with stable angina pectoris and diabetes mellitus

作　　者：姚璐 武云涛 田国祥[1] 张峰[1] 张薇 王剑飞 Yao Lu;Wu Yuntao;Tian Guoxiang;Zhang Feng;Zhang Wei;Wang Jianfei(Forth Cadre Department, the 7th Medical Center of the People's Liberation Army General Hospital, Beijing 100700, China)

机构地区：[1]解放军总医院第七医学中心干部病房四科,北京100700 [2]解放军总医院第七医学中心医疗科,北京100700

出　　处：《中国循证心血管医学杂志》2019年第7期807-810,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：军队医学科研课题面上项目(CWS11J216)

摘　　要：目的评价注射用尼可地尔短期静脉应用及口服尼可地尔片序贯治疗对老年冠状动脉粥样硬化性心脏病(冠心病)稳定型心绞痛合并糖尿病患者的临床疗效及安全性。方法选择2017年5月至2018年10月于解放军总医院第七医学中心干部病房四科住院的60例老年冠心病稳定型心绞痛合并糖尿病患者,随机分为观察组和对照组,每组各30例。对照组在常规治疗基础上加用丹参酮ⅡA磺酸钠注射液,观察组在对照组基础上联合注射用尼可地尔治疗,治疗14 d后观察两组患者临床疗效的改善情况。之后对照组患者维持原有常规口服药物治疗,观察组患者在常规药物基础上加用口服尼可地尔片序贯维持治疗。3个月后观察两组患者的心绞痛发作次数和发作持续时间、血糖水平变化及不良反应情况。结果短期内应用注射用尼可地尔联合丹参酮ⅡA磺酸钠可有效改善患者心绞痛的临床症状。在常规口服药物治疗基础上加用尼可地尔片序贯治疗3个月后,可明显减少患者心绞痛的发作次数及发作持续时间,且对患者的血糖无明显影响。对照组患者在整个治疗期间无明显不良反应发生。观察组在静脉应用注射用尼可地尔期间,有4例患者出现血压轻微下降,1例出现中度头痛,在口服尼可地尔片序贯治疗3个月内有1例患者出现轻微头痛,头痛出现在治疗早期。两组患者均未出现严重不良反应。结论无论是注射用尼可地尔静脉短期应用,还是口服尼可地尔片序贯维持治疗,对冠心病合并糖尿病患者均有较好的临床疗效,不影响患者血糖,且安全性较高。Objective To evaluate the clinical efficacy and safety of short-term intravenous nicorandil injection and sequential oral nicorandil tablets in elderly patients with stable angina pectoris and diabetes mellitus. Methods From May 2017 to October 2018, 60 elderly patients with stable coronary heart disease and angina pectoris complicated with diabetes who were hospitalized in the fourth department of the cadre ward of the 7 th medical center of the PLA general hospital were randomly divided into an observation group and a control group, with 30 patients in each group. The control group was treated on the basis of conventional treatment combined with tanshinone II A sulfonic acid sodium injection. The observation group was treated with nicorandil in combination with the control group.After 14 days of treatment, the improvement of clinical efficacy was observed in the two groups. After that, the control group patients maintained the original routine oral drug treatment, and the observation group patients received sequential oral maintenance treatment with nicorandil tablets on the basis of conventional drugs. Three months later, the number of episodes of angina pectoris, the duration of seizures, changes in blood glucose levels, and adverse reactions were observed. Result Short-term application of nicorandil combined with sodium tanshinone IIA sulfonate can effectively improve the clinical symptoms of angina pectoris. On the basis of conventional oral drug therapy, after sequential treatment with nicorandil for 3 months, the number of episodes of angina pectoris and duration of seizures can be significantly reduced, and there is no significant effect on the patient’s blood glucose. Patients in the control group had no significant adverse events during the entire treatment period. During the intravenous administration of nicorandil for intravenous injection, 4 patients had a slight decrease in blood pressure, 1 patient had a moderate headache, and 1 patient had a mild presentation within 3 months of oral nicorandil

关 键 词：注射用尼可地尔 尼可地尔片 丹参酮ⅡA磺酸钠 冠心病 2型糖尿病 老年 

分 类 号：R541.4[医药卫生—心血管疾病]