尼可地尔治疗慢性缺血性心肌病患者心力衰竭的临床效果及对再住院率的影响

Clinical effect of nicorandil on heart failure in patients with chronic ischemic cardiomyopathy and its influence on readmission rate

目的探讨尼可地尔治疗慢性缺血性心肌病患者心力衰竭的临床效果及对再住院率的影响。方法回顾性分析我院2016年8月至2017年8月收治的200例慢性缺血性心肌病心力衰竭患者的临床资料,根据治疗方法的不同将其分为常规组(n=100)和观察组(n=100)。常规组接受常规治疗,观察组在常规治疗的基础上给予尼可地尔。比较两组患者的心功能NYHA分级、临床疗效、心功能指标、不良反应发生情况、再住院情况及死亡情况。结果治疗后,两组患者的心功能NYHA分级均显著改善,且观察组优于常规组,差异具有统计学意义(P<0.05)。观察组的治疗总有效率为95.00%,显著高于常规组的82.00%,差异具有统计学意义(P<0.05)。治疗后,两组患者的LVEDD、LVESD均显著降低,LVEF均显著升高,且观察组优于常规组,差异具有统计学意义(P<0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。在治疗及随访的过程中,观察组患者的再住院率、死亡率分别为15.00%、0.00%,均显著低于常规组的28.00%、6.00%(P<0.05)。结论尼可地尔治疗慢性缺血性心肌病患者心力衰竭的临床效果显著,能够有效改善患者的心功能,降低再住院率,安全性高。

Objective To investigate the clinical effect of nicorandil on heart failure in patients with chronic ischemic cardiomyopathy and its influence on readmission rate.Methods The clinical data of 200 patients with chronic ischemic cardiomyopathy and heart failure admitted in our hospital from August 2016 to August 2017 were retrospectively analyzed.According to the different treatment methods,the patients were divided into routine group(n=100)and observation group(n=100).The routine group received routine treatment,while the observation group received nicorandil on the basis of routine treatment.The NYHA grading of cardiac function,clinical efficacy,cardiac function indexes,adverse reactions,readmission and death were compared between the two groups.Results After treatment,the NYHA grading of cardiac function in both groups significantly improved,and that in the observation group was better than the routine group,the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 95.00%,which was significantly higher than 82.00%in the routine group,the difference was statistically significant(P<0.05).After treatment,the LVEDD and LVESD in both groups significantly decreased and LVEF significantly increased,and those in the observation group were superior to the routine group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).In the course of treatment and follow-up,the readmission rate and death rate in the observation group were 15.00%and 0.00%respectively,which were significantly lower than 28.00%and 6.00%in the routine group(P<0.05).Conclusion Nicorandil is effective in treating heart failure in patients with chronic ischemic cardiomyopathy,which can effectively improve the cardiac function of patients and reduce the readmission rate,with high safety.