冠状动脉旁路移植术患者围手术期使用硝酸异山梨酯与硝酸甘油的疗效及对心功能的影响

Curative efficacy of Isosorbide nitrate and glycerin nitrate in treatment of of patients with coronary bypass grafting and its effectsoncardiac function

目的探讨冠状动脉旁路移植术患者围手术期使用硝酸异山梨酯与硝酸甘油的疗效及对心功能的影响。方法选取2015年6月至2018年3月该院收治的冠状动脉旁路移植术患者100例作为研究对象,采用随机数字表法分为观察组和对照组,每组50例。对照组使用硝酸甘油治疗,观察组使用硝酸异山梨酯治疗。比较两组患者的疗效、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)等。记录两组患者正常心肌百分比、室壁运动计分指数及不良反应发生情况。结果观察组患者总有效率明显高于对照组,差异有统计学意义(P<0.05);两组患者治疗前LVEDD、LVEF、LVESD,以及cTnI、CK-MB水平比较,差异均无统计学意义(P>0.05);两组患者治疗后LVEDD、LVESD,以及cTnI、CK-MB水平均明显下降,LVEF明显上升,且观察组患者治疗后LVEDD、LVESD,以及cTnI、CK-MB水平均明显低于对照组,LVEF明显高于对照组,差异均有统计学意义(P<0.05);观察组患者治疗后正常心肌百分比明显高于对照组,室壁运动计分指数、不良反应发生率均明显低于对照组,差异均有统计学意义(P<0.05)。结论在冠状动脉旁路移植术患者围手术期采用硝酸异山梨酯较硝酸甘油效果更显著,可明显改善心功能,降低不良反应发生率,值得推广应用。

Objective To study curative efficacy of Isosorbide nitrate and glycerin nitrate in treatment of Perioperative comparison of patients with coronary bypass graftingand its effectsoncardiac function. Methods 100 patients with coronary artery bypass grafting received treatment in the hospital from June 2015 to March 2018 were selected as the study subjects by randorn number table and were divided into the observation group ( n =50) and the control group ( n =50) by randorn number table.The control group was treated with nitroglycerin,and the observation group was treated with isosorbide nitrate.The curative effect,left ventricular end-diastolic diameter (LVEDD),left ventricular ejection fraction (LVEF),end systolic diameter (LVESD),troponin I (cTnI),creatine kinase isoenzyme (CK-MB) were compared in the two groups after treatment.The percentage of normal heart muscle,score index of ventricular wall movement and adverse reactions were recorded. Results The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant ( P < 0.05 ).There was no significant difference in LVEDD,LVEF and LVESD between the two groups before treatment ( P > 0.05 ).After treatment,LVEDD,LVESD,cTnI and CK-MB levels in both groups significantly decreased and LVEF significantly increased.LVEDD and LVESD in the observation group were significantly lower than those in the control group,and LVEF was significantly higher than that in the control group,and the difference was statistically significant ( P < 0.05 ).There was no significant difference in cTnI and ck-mb levels between the two groups before treatment.After treatment,cTnI and ck-mb levels in both groups decreased significantly ( P < 0.05 ).The cTnI and ck-mb levels of the observation group were lower than those of the control group ( P <0.05).After treatment,the percentage of normal heart muscle in the observation group was significantly higher than that in the control group,and the score index of ventricular wall movement and the incidence of adverse reactions were significantly lower than those in the control group,and the difference was statistically significant ( P <0.05). Conclusion In the perioperative period of patients undergoing coronary artery bypass grafting,the use of isosorbide nitrate is more effective than nitroglycerin,which can significantly improve cardiac function and reduce adverse reactions.Therefore,it is worthy of promotion and application.