尼可地尔治疗冠心病不稳定型心绞痛的临床疗效  

Clinical efficacy of nicorandil in the treatment of unstable angina pectoris of coronary heart disease

作　　者：林华[1] 王媛媛 郗昆 王绍明[2] Lin Hua;Wang Yuanyuan;Xi Kun;Wang Shaoming(Department of Cardiovascular Medicine,Changchun People' s Hospital,Changchun,Jilin,130051,China;Department of Endocrinae Medicine,Changchun People' s Hospital,Changchun,Jilin,130051,China)

机构地区：[1]长春市人民医院心血管内科,吉林长春130051 [2]长春市人民医院内分泌科,吉林长春130051

出　　处：《当代医学》2019年第31期34-36,共3页Contemporary Medicine

摘　　要：目的观察尼可地尔治疗冠心病不稳定型心绞痛的临床疗效及安全性。方法选取本院心内一科2019年1月至2019年4月住院的冠心病不稳定型心绞痛患者154例,采用随机单盲法分为两组。两组患者入院后均立即给予β受体阻滞剂、阿司匹林、氯吡格雷、他汀类降脂药物、低分子肝素治疗。在此基础上尼可地尔组给予尼可地尔治疗;异舒吉组给予异舒吉治疗。观察比较两组患者治疗效果,心电图疗效,ST段变化及不良反应情况。结果尼可地尔组心绞痛症状改善总有效率为96.1%,心电图改善总有效率为90.9%;异舒吉组心绞痛症状改善总有效率为89.6%,心电图改善总有效率为75.3%,两组比较差异具有统计学意义(P<0.05)。用药前与用药后,两组无症状心肌缺血(SMI)发作的次数,每次发作持续的时间比较差异均具有统计学意义(P<0.01),且两组组间比较差异具有统计学意义(P<0.01)。两组不良反应发生率比较差异无统计学意义,耐受性良好。结论尼可地尔能有效减少不稳定型心绞痛引起的胸闷、胸痛、心悸、气短、乏力等病症,同时可显著减少无症状心肌缺血的发生,可以作为治疗不稳定型心绞痛治疗的一线药物。Objective To observe the clinical efficacy and safety of nicorandil in the treatment of unstable angina pectoris of coronary heart disease. Methods A total of 154 patients with unstable angina pectoris of coronary heart disease from January 2019 to April 2019 were selected and randomly divided into two groups.Both groups were treated with beta blockers,aspirin,clopidogrel,statins and low molecular weight heparin immediately after admission.On this basis,nicorandil group was given nicorandil treatment;Isosorbide dinitrate group was given isosorbide dinitrate treatment. Observe and compare the therapeutic effects of the two groups,ECG efficacy,ST segment changes and adverse reactions.Results The total effective rate of improvement of angina symptom in nicorandil group was 96.1%,and the total effective rate of improvement of electrocardiogram was 90.9%.The total effective rate of improvement of angina symptom in isosorbide dinitrate group was 89.6%,and the total effective rate of improvement of electrocardiogram was 75.3%,there was significant difference between the two groups (P<0.05).Compared with before treatment, there were significant differences in the number of attacks of silent myocardial ischemia (SMI) and the duration of each attack between the two groups after treatment (P<0.01),and there were significant differences between the two groups (P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups,and they were well tolerated.Conclusion Nicorandil can effectively reduce chest tightness, chest pain,palpitation,shortness of breath,fatigue and other symptoms caused by unstable angina pectoris,and can significantly reduce the occurrence of asymptomatic myocardial ischemia.It can be used as a first-line drug for the treatment of unstable angina pectoris.

关 键 词：尼可地尔 不稳定型心绞痛 无症状心肌缺血 

分 类 号：R541.4[医药卫生—心血管疾病]