卡维地洛联合尼可地尔对冠心病心肌缺血及左室舒张功能的影响

Effect of carvedilol combined nicorandil on coronary heart disease and left ventricular diastolic dysfunction

目的探讨卡维地洛联合尼可地尔对冠心病心肌缺血及左室舒张功能不全的疗效。方法冠心病心肌缺血及左室舒张功能不全患者102例,单盲随机分为治疗组与对照组,对照组(51例)采用消心痛、阿司匹林及辛伐他汀治疗;治疗组(51例)采用卡维地洛、尼可地尔、阿司匹林及辛伐他汀,疗程均12周。治疗前后进行动态心电图、心脏彩色超声检测左室舒张功能、血浆氨基末端脑钠肽前体(NT-proBNP)等指标并作对比观察。结果 2组治疗后ST段压低的次数及其持续时间与心肌缺血总负荷均明显减少,但治疗组改善情况优于对照组(P<0.01),治疗组左室舒张功能指标显著改善,而对照组改善不明显,治疗组明显优于对照组(P<0.01),治疗组治疗后NT-proBNP(330.61±98.37)ng/ml,与治疗前(541.02±57.96)ng/nl比较显著下降(P<0.05),对照组治疗后(490.55±95.38)ng/ml与治疗前(550.12±70.28)ng/ml比较,差异无统计学意义(P>0.05),治疗组改善明显优于对照组(P<0.05)。结论卡维地洛联合尼可地尔能显著改善冠心病心肌缺血及左室舒张功能。

Objective To study the effect of carvedilol combined with nicorandil on myocardial ischemia of coronary heart disease and left ventricular diastolic dysfunction.Methods 102 cases of coronary heart disease with myocardial ischemia and left ventricular diastolic dysfunction were enrolled.They were single blind,randomly divided into treatment and control groups,the control group（51 cases） received of isosorbide dinitrale aspirin and simvastatine therapy,the treatment group（51 cases） received carvedilol,nicorandil,aspirin and simvastatine.After 12 weeks of treatment,before and after treatment,dynamic electrocardiogram and cardiac function of left ventricular diastolic function by color Doppler ultrasound,serum amino terminal Pro B type natriuretic peptide precursor（NT-proBNP） index were examined for comparison.Results ST segment depression times,continued time and myocardial deficiency blood total load were decreased in both of the 2 groups,but treatment group improved better than control group（P 0.05）,the improvement was more obvious in treatment group than control group（P 〈0.05）.Conclusion Carvedilol combined with nicorandil can significantly improve myocardial ischemia and left ventricular diastolic function in coronary heart disease.