单硝酸异山梨酯缓释片联合体外反搏治疗不稳定型心绞痛疗效观察

Therapeutic effect of isosorbide mononitrate sustained-release tablets combined with external counterpulsation on unstable angina pectoris

目的观察单硝酸异山梨酯缓释片联合体外反搏治疗不稳定型心绞痛(UAP)患者的临床疗效。方法选取长武县人民医院内五科2016年1月至2017年6月间收治的92例UAP患者作为研究对象,将入选患者按随机数字法均分为对照组和观察组,每组46例,对照组应用单硝酸异山梨酯缓释片治疗,观察组在对照组治疗的基础上联合应用体外反搏治疗;治疗36 d后评估两组患者的临床疗效,比较两组患者治疗前后的临床指标和主要症状的变化;随访一年,比较两组患者的心绞痛复发、急性心肌梗死(AMI)与心源性猝死的发生率。结果观察组患者的治疗总有效率为95.65%,明显高于对照组的82.61%,差异有统计学意义(P<0.05);治疗后观察组患者的ST段压低(0.06±0.01) m V/周、硝酸甘油用量(1.87±0.89) mg/周,对照组分别为(0.16±0.04) mV/周、(4.21±1.03) mg/周,观察组低于对照组,差异均有统计学意义(P<0.05);治疗后观察组患者的心绞痛发作次数为(0.07±0.39)次/周、发作持续时间为(1.08±0.62) min/次,对照组分别为(1.04±0.73)次/周、(2.35±0.73) min/次,观察组少于对照组,差异均有统计学意义(P<0.05);随访一年,观察组患者无心源性猝死发生,心绞痛复发和AMI总发生率为13.04%,对照组心绞痛复发、AMI与心源性猝死的总发生率为32.61%,观察组总发生率明显低于对照组,差异有统计学意义(P<0.05)。结论单硝酸异山梨酯缓释片联合体外反搏治疗不稳定型心绞痛临床疗效较好,其可更有效的改善患者临床症状,且远期疗效优势明显。

Objective To observe the clinical efficacy of isosorbide mononitrate sustained release tablets combined with external counterpulsation in the treatment of patients with unstable angina pectoris (UAP). Methods A total of 92 UAP patients admitted to the Fifth Department of Internal Medicine at Changwu People's Hospital from January 2016 to June 2017 were selected as subjects. The selected patients were divided into control group and observation group according to random number method, with 46 cases in each group. The control group was treated with isosorbide mononitrate sustained-release tablets, and the observation group was further treated with external counterpulsation on the basis of the treatment of the control group. After 36 days of treatment, the clinical efficacy of the two groups was evaluated, and the clinical indicators and main symptoms of the two groups were compared before and after treatment. During the follow-up for one year, the incidence of angina recurrence, acute myocardial infarction (AMI), and sudden cardiac death was compared between the two groups. Results The total effective rate of treatment in the observation group was 95.65%, which was significantly higher than 82.61% in the control group, and the difference was statistically significant (P<0.05). After treatment, the ST-segment depression was (0.06±0.01) mV/week, and the dosage of nitroglycerin was (1.87±0.89) mg/week;the corresponding value in the control group was (0.16±0.04) mV/week and (4.21±1.03) mg/week. The value of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the number of angina attacks and the attack duration in the observation group was (0.07±0.39) times/week and (1.08±0.62) min/time, respectively;and the corresponding value in the control group was (1.04±0.73) times/week and (2.35±0.73) minutes/time. The value of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). One year follow-up showed that there was no sudden cardiac death in the observation group, the total incidence of angina recurrence and AMI in the observation group was 13.04%;and the total incidence of angina recurrence, AMI and sudden cardiac death in the control group was 32.61%. The total incidence in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Isosorbide mononitrate sustained release tablets combined with external counterpulsation have better clinical effects in the treatment of unstable angina pectoris, which can improve the clinical symptoms of patients more effectively, and the long-term efficacy has obvious advantages.