长春西汀治疗急性冠脉综合征合并高血压的临床观察

Clinical Observation of Vinpocetine in the Treatment of Acute Coronary Syndrome with Hypertension

目的:观察长春西汀治疗急性冠脉综合征(ACS)合并高血压的疗效和安全性。方法:90例ACS合并高血压患者随机分为对照组(45例)和观察组(45例)。对照组患者给予阿托伐他汀钙片20 mg,口服,每日1次+硫酸氢氯吡格雷片75 mg,口服,每日1次+苯磺酸左旋氨氯地平片2.5 mg,口服,每日1次+单硝酸异山梨酯缓释片40 mg,口服,每日1次。观察组患者在对照组治疗的基础上给予长春西汀注射液30 mg,加入0.9%氯化钠注射液或5%葡萄糖注射液250 ml中,静脉滴注,每日1次。两组疗程均为14 d。观察两组患者的临床疗效、治疗前后收缩压(SBP)、舒张压(DBP)、心绞痛发作频率、持续时间、发作间隔时间、ST段下移、血液黏度、D-二聚体、血小板聚集率、纤维蛋白原水平及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者SBP、DBP、心绞痛发作频率、持续时间、发作间隔时间、ST段下移、血液黏度、D-二聚体、血小板聚集率、纤维蛋白原水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者SBP、DBP均显著低于同组治疗前,差异均有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05);发作频率、持续时间、ST段下移、血液黏度、D-二聚体、血小板聚集率、纤维蛋白原水平均显著低于同组治疗前,且观察组低于对照组,发作间隔时间显著长于同组治疗前,且观察组长于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:在常规治疗的基础上,长春西汀治疗ACS合并高血压的疗效和安全性均较好。

OBJECTIVE： To observe the efficacy and safety of vinpocetine in the treatment of acute coronary syndrome （ACS） with hypertension. METHODS： 90 patients with ACS and hypertension were randomly divided into control group （45 cases） and observation group （45 cases）. Control group received Atorvastatin calcium tablet 20 mg, orally, once a day＋Clopidogrel hydrogen sulfate tablet 75 mg, orally, once a day＋Levamlodipine besylate tablet 2.5 mg, orally, once a day＋Isosorbide mononitrate sus- tained-release tablet 40 mg, orally, once a day. Observation group was additionally given Vinpocetine injection 30 mg, adding into 0.9% Sodium chloride injection or 5% Glucose injection 250 ml by intravenous infusion, once a day. The 2 groups were treated for 14 d. The clinical efficacy, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, attack frequency, duration, inter- val time of the attack, ST segment down, blood viscosity, D-dimer, platelet aggregation rate, fibrinogen levels before and after treatment, and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total effective rate in observation group was significantly higher than control group, with statistical significance （P〈0.05）. Before treatment, there were no signifi- cant differences in SBP, DBP, attack frequency, duration, interval time of the attack, ST segment down, blood viscosity, D-di- met, platelet aggregation rate, fibrinogen levels in 2 groups （P〉0.05）. After treatment, SBP and DBP in 2 groups were significant- ly lower than before, with statistical significance （P〈0.05）, while there was no significant difference in 2 groups （P〉0.05）. At- tack frequency, duration, ST segment down, blood viscosity, D-dimer, platelet aggregation rate, fibrinogen levels in 2 groups were significantly lower than before, and observation group was lower than control group, interval time of the attack in 2 groups was significantly long than before, and observation group was longer than control group, with statistical significances （P〈0.05）. And there was no significant difference in the incidence of adverse reactions in 2 groups （P〉0.05）. CONCLUSIONS： Based on the conventional treatment, both efficacy and safety of vinpocetine in the treatment of ACS with hypertension are good.