唑吡坦对老年不稳定性心绞痛伴自述失眠患者的临床疗效评价  

Clinical efficacy evaluation of zolpidem on elderly unstable angina pectoris patients with self-reported insomnia

作　　者：赵红亮[1] 张慧杰 高改玲 王升 贾玮玲 魏立业[1] 夏岳[1] 戚国庆[1] ZHAO Hong-liang;ZHANG Hui-jie;GAO Gai-ling;WANG Sheng;JIA Wei-ling;WEI Li-ye;XIA Yue;QI Guo-qing(Department of Cardiology,First Hospital,Hebei Medical University,Hebei Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院心内科,河北石家庄050031

出　　处：《中国医院药学杂志》2021年第6期612-615,共4页Chinese Journal of Hospital Pharmacy

基　　金：河北省科技厅基金项目(编号:182777229);河北省卫健委基金项目(编号:20190449)。

摘　　要：目的:观察唑吡坦对老年不稳定性心绞痛(UAP)伴自述失眠(SRI)患者治疗30 d临床疗效及预后的影响。方法:选取2016年6月至2019年6月收治的99例老年UAP伴SRI患者,随机分为对照组50例和治疗组49例,2组均给予常规冠心病二级预防用药。治疗组同时加用唑吡坦5 mg每晚睡前口服,对照组则给予安慰剂,2组疗程均为30 d。运用匹兹堡睡眠质量指数(PSQI)评估患者睡眠质量及SRI临床疗效,比较2组患者肌钙蛋白I(cTnI)、心型脂肪酸结合蛋白(H-FABP)和脑钠肽(BNP)水平,评价UAP临床疗效。同时观察2组患者30 d心血管事件发生情况。结果:治疗30 d后2组的PSQI评分均有下降(P<0.05),治疗组下降程度高于对照组(P<0.05);治疗组SRI治疗总有效率(89.8%)优于对照组(68.0%),组间比较存在差异(P<0.05)。治疗后2组cTnI、H-FABP和BNP水平均有所下降(P<0.05),治疗组比对照组下降明显(P<0.05);治疗组UAP治疗总有效率(91.8%)优于对照组(72.0%),组间比较差异显著(P<0.05)。治疗组30 d心血管事件发生率为10.2%,优于对照组的18.0%(P<0.05)。结论:唑吡坦对老年UAP伴SRI患者具有心肌保护作用,能够明显改善患者的SRI疗效,并能在常规冠心病二级预防用药基础上明显改善患者UAP治疗效果,降低30 d心血管事件发生率、改善患者预后。OBJECTIVE To observe the 30 day efficacy and prognosis of zolpidem in elders with unstable angina pectoris(UAP)and self-reported insomnia(SRI).METHODS A total of 99 UAP elders with SRI from June 2016 to June 2019 were randomly divided into control group(n=50)and treatment group(n=49).Both groups received conventional secondary prophylactic drugs for coronary heart disease(CHD).The treatment group took 5 mg zolpidem every night before bedtime while the control group received a placebo.Pittsburgh sleep quality index(PSQI)was utilized for evaluating sleep quality and clinical efficacy of SRI.The levels of troponin I(cTnI),cardiac fatty acid binding protein(H-FABP)and brain natriuretic peptide(BNP)of two groups were compared and the clinical efficacy of UAP was evaluated.Meanwhile, 30 day cardiovascular events were observed in two groups.RESULTS After 30 day treatment, PSQI scores decreased in both groups(P<0.05)and the decremental magnitude of treatment group was more obvious than that of control group(P<0.05).The total effective rate of SRI was better in treatment group than that in control group(89.8% vs 68.0%).The levels of cTnI,H-FABP and BNP all decreased in two groups after treatment(P<0.05)and the levels decreased significantly in treatment group(P<0.05).The total effective rate of UAP was better in treatment group than that in control group(91.8% vs 72.0%)and the inter-group difference was significant(P<0.05).The incidence of 30-days cardiovascular events was lower in treatment group than that in control group(10.2% vs 18.0%,P<0.05).CONCLUSION Zolpidem has myocardial protective effect on UAP elders with SRI,improves the clinical efficacies of SRI and UAP on the basis of conventional secondary preventive drugs for CHD,reduces the incidence of 30-days cardiovascular events and improves the prognosis of patients.

关 键 词：唑吡坦 老年患者 不稳定性心绞痛 自述失眠 疗效 预后 

分 类 号：R541.4[医药卫生—心血管疾病] R971.3[医药卫生—内科学]