曲美他嗪联合替格瑞洛治疗不稳定型心绞痛合并慢性心力衰竭的临床效果观察

Clinical effect of trimetazidine combined with ticagrelor in the treatment of unstable angina pectoris compli-cated with chronic heart failure

目的 观察曲美他嗪联合替格瑞洛治疗不稳定型心绞痛(UAP)并慢性心力衰竭(CHF)患者的临床疗效及安全性.方法 选择2016年1月至2018年9月台州市肿瘤医院收治的不稳定型心绞痛合并慢性心力衰竭患者60例进行前瞻性研究,采用随机数字表法进行分组,两组各30例,对照组给予替格瑞洛治疗,观察组给予替格瑞洛联合曲美他嗪治疗,比较两组:(1)临床疗效;(2)心绞痛发作情况;(3)心功能指标;(4)不良反应.结果 临床总有效率分别为96.67%(观察组)、80.00%(对照组),观察组较对照组高(χ^2 =4.043,P<0.05);治疗后3 个月内,观察组的心绞痛发作次数[(6.59 ± 1.32)次]、单次心绞痛持续时间[(2.24 ± 0.92)min],均较对照组减少(t=4.277、4.076,均 P<0.05);观察组的左心射血分数[(49.36 ± 6.25)%]、每搏输出量[(76.29 ± 5.31)mL]均高于对照组(t=4.066、4.093,均 P <0.05),其脑钠肽水平[(378.32 ± 27.82)μg/L]低于对照组(t=4.152,P<0.05);不良反应总发生率分别为6.67%(观察组)、3.33%(对照组),两组差异无统计学意义(χ^2 =0.351,P>0.05).结论 替格瑞洛与曲美他嗪联合用药可有效减少心绞痛发作,改善心功能,对不稳定型心绞痛合并慢性心力衰竭具有良好的有效性和安全性.

Objective To observe the clinical efficacy and safety of trimetazidine combined with ticagrelor in the treatment of unstable angina pectoris(UAP)complicated with chronic heart failure(CHF).Methods From January 2016 to September 2018,60 UAP patients complicated with CHF in Taizhou Cancer Hospital were selected and randomly divided into two groups according to the random number table method,with 30 cases in each group.The control group was given ticagrelor,while the observation group was given ticagrelor+trimetazidine.The clinical efficacy,angina attack,cardiac function indicators,adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 96.67%,which was higher than 80.00%of the control group(χ^2 =4.043,P<0.05).With in 3 months after treatment,the number of angina attacks(6.59 ± 1.32)times and the duration of single angina pectoris [(2.24 ± 0.92)min] in the observation group were all lower than those in the control group(t=4.277,4.076,all P <0.05).After treatment,the left ventricular ejection fraction [(49.36 ± 6.25)%] and stroke output [(76.29 ± 5.31)mL] of the observation group were higher than those of the control group(t=4.066,4.093,all P<0.05),and the level of brain natriuretic peptide [(378.32 ± 27.82)μg/L] of the observation group was lower than that of the control group(t =4.152,P <0.05).The incidence rate of adverse reactions of the observation group was 6.67%,which of the control group was 3.33%,there was no statistically significant difference between the two groups(χ^2 =0.351,P>0.05).Conclusion The combination of ticagrelor and trimetazidine can effectively reduce the attack of angina pectoris,improve cardiac function and has less adverse reactions.It is effective and safe for UAP patients complicated with CHF.