地尔硫䓬联合阿托伐他汀及美托洛尔治疗不稳定型心绞痛的临床效果

Clinical effect of diltiazem combined with atorvastatin and metoprolol in the treatment of unstable angina pectoris

目的 观察地尔硫䓬联合阿托伐他汀及美托洛尔治疗不稳定型心绞痛(UAP)的临床效果。方法 回顾性选取2021年1月—2022年8月广东省第二人民医院收治的62例UAP患者为研究对象,按照治疗方法不同分为对照组(n=30)与观察组(n=32)。对照组给予阿托伐他汀联合美托洛尔,观察组在对照组的基础上加用地尔硫䓬。2组患者均连续治疗1个月。比较2组临床疗效,治疗前及治疗1个月后心绞痛发作情况、心功能指标、血脂指标,不良反应。结果 观察组总有效率为93.75%,高于对照组的70.00%(χ^(2)=5.984,P=0.014)。治疗1个月后,2组心绞痛发作次数较治疗前减少,心绞痛发作持续时间较治疗前缩短,且观察组变化幅度大于对照组(P<0.01);2组左心室射血分数(LVEF)较治疗前升高,左心室舒张末期内径(LVEDD)及左心室收缩末期内径(LVESD)较治疗前缩小,且观察组LVEF高于对照组,LVEDD、LVESD小于对照组(P<0.05或P<0.01);2组血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平较治疗前降低,血清高密度脂蛋白胆固醇(HDL-C)水平较治疗前升高,且观察组变化幅度大于对照组(P<0.01)。观察组、对照组不良反应总发生率分别为12.50%、10.00%,组间比较,差异无统计学意义(χ^(2)=0.008,P=0.928)。结论 地尔硫䓬与阿托伐他汀及美托洛尔联合治疗UAP的疗效确切,可有效缓解心绞痛发作症状,改善心功能及血脂,促进心功能恢复,且联合用药安全性较高。

Objective To observe clinical effect of diltiazem combined with atorvastatin and metoprolol in the treatment of unstable angina pectoris(UAP).Methods The clinical data of 62 cases of UAP patients admitted from January 2021 to August 2022 in Guangdong Second Provincial General Hospital were analyzed retrospectively,according to different treatment methods,they were divided into the control group(n=30)and the observation group(n=32).The control group was given atorvastatin combined with metoprolol,and the observation group was given diltiazem on the basis of the control group.Patients in the two groups were treated continuously for one month.Clinical effect,angina pectoris attacks,cardiac function indexes,blood lipid indexes before and after one month of treatment,adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 93.75%,which was higher than 70.00%of the control group(χ^(2)=5.984,P=0.014).After one month of treatment,the number of angina pectoris attacks in the two groups decreased compared with that before treatment,and duration of angina pectoris attacks was shorter than that before treatment,and the amplitude of variation in the observation group was greater than that in the control group(P<0.01);the LVEF of the two groups increased compared with that before treament,and the LVEDD and LVESD decreased,and the LVEF of the observation group was higher than that of the control group,while the LVEDD and LVESD were less than those of the control group(P<0.05 or P<0.01);the serum levels of TC,TG and LDL-C in the two groups were lower than those before treatment,the serum level of HDL-C was higher than that before treatment,and the amplitude of variation in the observation group was greater than that in the control group(P<0.01).The total incidence of adverse reactions in the observation group and the control group was 12.50%and 10.00%,respectively,and there was no statistical difference between the two groups(χ^(2)=0.008,P=0.928).Conclusion Diltiazem combined with atorvastatin and metoprolol have an exact clinical effect for UAP,which can effectively relieve the symptoms of angina pectoris,improve the cardiac function and blood lipid,and promote the cardiac function recovery,and the safety of combined medication is high.