硝苯地平联合曲美他嗪治疗冠心病稳定型心绞痛的临床效果

Effects of nifedipine combined with trimetazidine on stable angina pectoris of coronary heart disease

目的探讨硝苯地平联合曲美他嗪治疗冠心病稳定性心绞痛的临床效果。方法选取山西省一〇九医院2016年7月至2018年6月心内科收治的68例冠心病稳定型心绞痛为研究对象,采用随机数字表分为对照组与观察组,每组34例。对照组予以阿司匹林、硝酸异山梨酯、曲美他嗪等降脂、缓解胸痛等治疗,观察组在对照组治疗基础上加用硝苯地平缓释片。评估两组治疗效果、检测治疗前后两组血生化指标及心电图情况,并记录不良反应。结果对照组总有效率(67.65%)低于观察组(88.24%,P<0.05)。治疗后观察组三酰甘油(TG)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)改善程度优于对照组(P<0.05);治疗后观察组ST段下降导联数(NST)、ST段压低总和(ΣST)及ST段降低时间均低于对照组(P<0.05)。治疗后两组血管性血友病因子(vWF)、内皮素1(ET-1)水平低于治疗前,血清一氧化氮(NO)水平高于治疗前,且观察组各指标均优于对照组(P均<0.05)。对照组不良反应总发生率(11.76%)与观察组(8.82%)比较,差异未见统计学意义(P>0.05)。结论硝苯地平联合曲美他嗪治疗冠心病稳定性心绞痛,可显著改善患者心绞痛发作症状,有效调节机体血脂平衡,疗效较好。

Objective To investigate the effects of nifedipine combined with trimetazidine on blood biochemical indexes and electrocardiogram in patients with stable angina pectoris of coronary heart disease. Methods A total of 68 patients with stable angina pectoris of coronary heart disease treated in the Department of Cardiology in the 109th Hospital of Shanxi from July 2016 to June 2018 were selected for the study, and they were divided into the control group and the observation group according to the random number table method, with 34 cases in each group. The control group was treated with aspirin, isosorbide dinitrate, trimetazidine and other lipid-lowering, chest pain relieving treatment. The observation group was additionally given nifedipine on the basis of treatment in the control group. The curative effect was evaluated, the blood biochemical indexes and electrocardiogram condition in the two groups were measured before and after treatment, adverse reactions were recorded. Results The total effective rate(67.65%) in the control group was lower than that in the observation group(88.24%, P<0.05). After treatment, the improvement degree of triglyceride, low density lipoprotein and high density lipoprotein in observation group were better than those in the control group(P<0.05). The NST,ΣST and decreasing times of ST segments were lower than those in the control group (P<0.05). After treatment, the levels of von willebrand factor and endothelin-1 were significantly lower than those before treatment, while the level of NO was higher than that before treatment in both groups, the indexes in the observation group were better than those in the control group (P<0.05). There was no significant difference in the overall incidence of adverse reactionsin between the control group (11.76%) and in the observation group (8.82%, P>0.05). Conclusions Nifedipine combined with trimetazidine in the treatment of stable angina pectoris of coronary heart disease can significantly improve the symptoms of angina pectoris and effectively regulate the body lipid balance, with good effects.