尼可地尔治疗高龄冠心病不稳定心绞痛患者的疗效观察  

clinical observation of nicorandil in the treatment of unstable angina pectoris in elderly patients with coronary heart disease

作　　者：马章鲁 Ma Zhanglu(First Department of Cardiology,Juye County People's Hospital of Heze City,Heze 274900,China)

机构地区：[1]山东省菏泽市巨野县人民医院心内一科,274900

出　　处：《现代养生》2023年第9期655-658,共4页Health Protection and Promotion

摘　　要：目的 探讨尼可地尔对高龄冠心病不稳定心绞痛患者疗效及对患者血管内皮功能和心功能影响。方法选择医院于2019年9月-2021年9月收治的冠心病不稳定心绞痛患者142例作为研究对象,依据组间性别、年龄、纽约心脏病协会(NYHA)心功能分级、基础疾病分为观察组71例与对照组71例。对照组患者采用常规治疗,观察组在对照组基础上结合尼可地尔治疗;各治疗4周。比较两组疗效,治疗前后心绞痛持续时间、硝酸甘油用量和心绞痛发作频率变化,治疗前后血管内皮功能和心功能变化及不良反应。结果 观察组总有效率(92.96%)高于对照组(77.46%),差异有统计学意义(P<0.05)。治疗前,两组患者心绞痛持续时间、硝酸甘油用量和心绞痛发作频率比较,差异无统计学意义(P>0.05);治疗后,两组上述指标均较治疗前降低,但观察组治疗后心绞痛持续时间、硝酸甘油用量和心绞痛发作频率低于对照组,差异有统计学意义(P<0.05)。治疗前,两组血浆一氧化氮(NO)和内皮素-1(ET-1)水平比较,差异无统计学意义(P>0.05);治疗后,两组血浆NO水平升高,ET-1水平降低,但观察组血浆NO水平高于对照组,ET-1水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组每搏输出量(SV)、左心室射血分数(LVEF)和左室舒张末期内径(LVEDD)比较,差异无统计学意义(P>0.05);治疗后,两组SV和LVEF升高,LVEDD降低,但观察组SV和LVEF高于对照组,LVEDD低于对照组,差异有统计学意义(P<0.05)。两组均未发生明显不良反应。结论 尼可地尔对高龄冠心病不稳定心绞痛患者疗效良好,且可改善患者血管功能和心功能,无明显不良反应,安全性良好。Objective To investigate the effect of nicorandil on vascular endothelial function and cardiac function in elderly patients with unstable angina pectoris caused by coronary heart disease.Methods Totally 142 patients with unstable angina pectoris of coronary heart disease admitted by the hospital from September 2019 to September 2021 were selected as the study subjects,and they were divided into the observation group and the control group according to gender,age,NYHA classification of cardiac function and basic disease,71 cases per group.The patients in the control group were treated with conventional therapy,while the patients in the observation group were treated with nicorandil on the basis of the control group.Each treatment lasted for 4 weeks.The curative effects of the two groups were compared,including the duration of angina pectoris,the amount of nitroglycerin and the frequency of angina pectoris before and after treatment,the changes of vascular endothelial function and cardiac function and adverse reactions before and after treatment.Results The total effective rate of the observation group(92.96%)was higher than that of the control group(77.46%),and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the duration of angina pectoris,the amount of nitroglycerin and the frequency of angina pectoris between the two groups(P>0.05).After treatment,the above indexes in both groups were lower than those before treatment,but the duration of angina pectoris,the amount of nitroglycerin and the frequency of angina pectoris in the observation group were lower than those in the control group after treatment,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference between the two groups in plasma nitric oxide(NO)and endothelin-1(ET-1)levels(P>0.05).After treatment,the plasma NO level of the two groups increased and the ET-1 level decreased,but the plasma NO level of the observation group was higher than that o

关 键 词：尼可地尔 冠心病 不稳定心绞痛 血管内皮功能 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]