单硝酸异山梨酯联合尼可地尔治疗心力衰竭的效果  

Effect of isosorbide mononitrate combined with nicorandil in the treatment of heart failure

作　　者：常国花 陈海云 张峰 赵连连 CHANG Guohua;CHEN Haiyun;ZHANG Feng(Department of Cardiology,Dongying District People's Hospital,Shandong,Dongying 257000,China)

机构地区：[1]山东省东营市东营区人民医院心内科,257000 [2]山东省东营市东营区人民医院儿科,257000 [3]山东省东营市东营区人民医院老年医学科,257000 [4]山东省东营市人民医院心内科

出　　处：《河北医药》2024年第24期3750-3753,共4页Hebei Medical Journal

基　　金：吴阶平医学基金会临床科研专项资助基金课题(编号:320.6750.18570)。

摘　　要：目的探讨单硝酸异山梨酯联合尼可地尔治疗老年心力衰竭的效果。方法选取2021年1月至2022年6月94例老年心力衰竭患者,根据随机数表法分为对照组(行单硝酸异山梨酯治疗)和观察组(行单硝酸异山梨酯+尼可地尔治疗),每组47例,观察其应用效果。结果观察组总有效率较对照组高(P<0.05);2组患者治疗后左心室舒张末期内径(LVEDD)、室间隔厚度(IVST)、肌钙蛋白I(cTnI)及氨基末端脑钠肽前体(NT-proBNP)水平均低于治疗前,左心室射血分数(LVEF)水平均高于治疗前,且观察组LVEDD、IVST、cTnI及NT-proBNP水平较对照组低,LVEF水平较对照组高(P<0.05);2组治疗后的血清一氧化氮(NO)水平均高于治疗前,血清内皮素-1(ET-1)水平均低于治疗前,且观察组NO水平较对照组高,ET-1水平较对照组低(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论单硝酸异山梨酯联合尼可地尔可改善老年心力衰竭疗效、心脏舒张功能、心力衰竭标志物水平及血管内皮功能,且不会增加不良反应。Objective To investigate the effect of isosorbide mononitrate combined with nicorandil in the treatment of senile heart failure.Methods A total of 94 elderly patients with heart failure treated from January 2021 to June 2022 were enrolled and divided into control group(treated with isosorbide mononitrate,n=47)and observation group(treated with isosorbide mononitrate+nicorandil,n=47)according to random number table method.The application effects were assessed.Results The total effective rate of observation group was significantly higher than that of control group(P<0.05).After treatment,significantly lower left ventricular end-diastolic diameter(LVEDD),interventricular septal thickness(IVST),troponin I(cTnI)and N-terminal pro-brain natriuretic peptide(NT-proBNP),and higher left ventricular ejection fraction(LVEF)were detected in both groups after treatment,which were significantly pronounced in the observation group(P<0.05).The serum nitric oxide(NO)significantly increased and serum endothelin-1(ET-1)significantly decreased after treatment in both groups,which were significantly pronounced in the observation group(P<0.05).There was no significant difference in the incidence of adverse events between groups(P>0.05).Conclusion Isosorbide mononitrate combined with nicorandil can improve the efficacy,diastolic function levels of heart failure markers and vascular endothelial function in elderly patients with heart failure without increasing adverse events,which has a high clinical application value.

关 键 词：单硝酸异山梨酯 尼可地尔 老年心力衰竭 心脏舒张功能 

分 类 号：R541.6[医药卫生—心血管疾病]