尼可地尔对冠心病合并2型糖尿病不完全血运重建术后的疗效观察

The efficacy of Nicorandil in Patients with Multivessel Coronary Artery Disease Complicated with Type 2 Diabetes Undergoing Incomplete Revascularization

目的:比较尼可地尔与单硝酸异山梨酯对冠心病合并2型糖尿病患者不完全血运重建术后的疗效。方法:入选112例经皮冠状动脉介入治疗(PCI)部分血运重建的冠心病合并2型糖尿病患者。随机分为2组:尼可地尔组(5 mg,3次/d,口服)60例,单硝酸异山梨酯组(50 mg,1次/d,口服)52例,两组患者均给予常规冠心病及糖尿病药物治疗。术后4周末行运动负荷试验,观察总运动时间,从开始运动到出现ST段压低1.0 mv和出现心绞痛的时间(s),以及最大ST段压低幅度,同时记录每周心绞痛发作次数及硝酸甘油用量。结果:4周后两组患者同服药前比较,从开始运动到出现ST段压低1.0 mv的时间延长,总运动时间延长,从开始运动到出现心绞痛的时间延长,最大ST段压低幅度降低(P<0.01),但尼可地尔组与单硝酸异山梨酯组比较无明显统计学差异(P>0.05);尼可地尔组每周心绞痛发作次数及硝酸甘油用量明显少于单硝酸异山梨酯组(P<0.05)。结论:尼可地尔可增加冠心病合并糖尿病患者行不完全血运重建术后患者运动耐量,在减少心绞痛方面作用优于单硝酸异山梨酯。

Objective：To assess the efficacy between Nicorandil and isosorbide mononitrate in patients with multivessel coronary artery disease complicated with type 2 Diabetes undergoing incomplete revascularization by percutaneous coronary intervention（PCI）.Methods：Patients（n=112） with multivessel coronary artery disease complicated with type 2 Diabetes suffered incomplete revascularization by PCI were randomly divided into 2 groups：Nicorandil group（N=60） and isosorbide mononitrate group（N=52）.Exercise tolerance test,number of weekly angina attacks,nitroglycerin consumption were evaluated.Results：Both groups improve the total exercise time and the time to 1 mv ST-segment depression in an exercise tolerance test,there was no significant difference between the two groups,however,Nicorandil significantly decreased the number of angina attacks and nitroglycerin consumption.Conclusions：Nicorandil may have better antianginal effect than isosorbide mononitrate as treatment for patients after incomplete revascularization by PCI with type 2 Diabetes.