地尔硫卓与富马酸比索洛尔、阿托伐他汀钙联合治疗冠心病UAP患者的临床疗效  

Effects of diltiazem combined with bisoprolol fumarate and atorvastatin calcium in the treatment of patients with UAP of coronary heart disease

作　　者：周春娟 桑海强[2] Zhou Chun-juan;Sang Hai-qiang(Department of Internal Medicine,Wenxian Second People's Hospital,Jiaozuo 454850,Henan,China;Department of Cardiology,Zhengdong Hospital,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]温县第二人民医院内科,河南焦作454850 [2]郑州大学第一附属医院郑东院区心内科,河南郑州450000

出　　处：《四川生理科学杂志》2025年第4期713-715,837,共4页

基　　金：河南省医学科技攻关联合共建项目(编号:LHGJ20207118)。

摘　　要：目的:探讨地尔硫卓与富马酸比索洛尔、阿托伐他汀钙联合治疗冠心病不稳定型心绞痛(Unstable angina pectoris,UAP)患者的临床效果。方法:回顾性选取2021年7月至2023年9月温县第二人民医院收治的89例UAP患者,根据治疗方案不同,分为双药组(n=44)和三药联合组(n=45),双药组口服富马酸比索洛尔2.5 mg和阿托伐他汀钙10 mg Qd治疗,三药联合组在双药组基础上口服地尔硫卓30 mg Tid治疗。治疗3 m后,对比两组临床疗效、不良反应发生情况;治疗前后,记录患者心绞痛发作频率、心绞痛持续时间;采用电子血压计测量患者心率、血压,使用心脏多普勒超声仪检测患者心排出量(Cardiac output,CO)、左心室射血分数(Left ventricular ejection fraction,LVEF)、左心室舒张末期内径(Left ventricular end diastolic diameter,LVEDD),酶联免疫吸附法检测血清P选择素、基质金属蛋白酶-9(Matrixmetallo proteinase-9,MMP-9)、髓过氧化物酶(Myeloperoxidase,MPO)水平。结果:治疗3m后,三药联合组总有效率高于双药组,心绞痛发作频率、心绞痛持续时间、收缩压、舒张压、心率均低于双药组(P<0.05);三药联合组LVEF、CO高于双药组,LVEDD、血清P选择素、MMP-9、MPO水平均低于双药组(P<0.05);两组不良反应发生率对比,无明显差异(P>0.05)。结论:三药联合治疗UAP安全、有效,可减轻临床症状,改善心功能,控制病情进展。Objective:To investigate the clinical effect of diltiazem combined with bisoprolol fumarate and atorvastatin calcium in treating patients with unstable angina pectoris(UAP)of coronary heart disease.Methods:A total of 89 UAP patients admitted to Wenxian Second People's Hospital from July 2021 to September 2023 were retrospectively selected and divided into two-drug group(n=44)and three-drug combined group(n=45)according to different treatment schemes,two-drug group received oral bisoprolol fumarate 2.5 mg Qd and oral atorvastatin calcium 10 mg Qd,three-drug combined group received oral diltiazem 30 mg Tid based on two-drug group.After 3 months of treatment,the efficacy and adverse reactions were compared between the two groups;before and after treatment,the frequency of angina attacks and duration of angina were recorded,and heart rate and blood pressure were measured by blood pressure monitors,cardiac output(CO),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)were detected by cardiac Doppler ultrasound,P-selectin,matrix metallo proteinase-9(MMP-9),myeloperoxidase(MPO)were detected by enzyme-linked immunosorbent assay.Results:After 3 months of treatment,the total effective rate in the three-drug combined group was higher than that in the two-drug group,the frequency of angina attack,duration of angina,systolic blood pressure,diastolic blood pressure,and heart rate were lower than those in the two-drug group(P<0.05);LVEF and CO in the three-drug combined group were higher than those in the two-drug group,LVEDD,the serum levels of P-selectin,MMP-9 and MPO were lower than those in the two-drug group(P<0.05);the incidence of adverse reactions had no significant difference between the two groups(P>0.05).Conclusion:Three drugs combination therapy is safe and effective for UAP,which can alleviate clinical symptoms,improve cardiac function,and control disease progression.

关 键 词：不稳定型心绞痛 地尔硫卓 富马酸比索洛尔 阿托伐他汀钙 

分 类 号：R541.4[医药卫生—心血管疾病]