摘要
目的探讨小剂量阿米替林在冠状动脉介入术(PCI)术后反复发作不典型胸痛的患者中的治疗价值。方法将126例PCI术后不典型胸痛反复发作的患者分为试验组(65例)及对照组(62例),两组分别加用小剂量阿米替林和强化冠心病药物治疗并随访12周,观察两组患者症状改善情况,比较随访期间的就医次数及两组患者治疗前后的汉密顿焦虑量表(HAMA-14)及汉密顿抑郁量表(HAMD-17)评分变化,观察小剂量阿米替林长期使用的安全性。结果试验组患者在随访第4周末、第8周末及第12周末治疗有效率分别为38.5%、73.8%和80.0%;对照组分别为24.6%(P>0.05)、45.9%(P<0.05)和59.0%(P<0.05)。试验组及对照组总就诊次数分别为2(1,2)和2(2,3)(P<0.05)。治疗12周末,试验组HAMA-14及HAMD-17评分较入组时显著降低(P<0.05),对患者白细胞、血小板、肝功能、肾功能、低密度脂蛋白胆固醇、脑钠肽前体及血糖指标均未见不良影响。结论小剂量阿米替林安全、有效,可显著改善PCI术后不典型胸痛患者的临床症状,减少患者就医次数。
Objective To investigate the treatment value of small dose amitriptyline in the patients with recurrent untypical chest pain after percutaneous coronary intervention(PCI).Methods One hundred and twenty-six patients with recurrent untypical chest pain after PCI were divided into the experimental group(n=65)and control group(n=62).Small dose amitriptyline and enhanced coronary drug therapy were respectively added in the two groups,the follow up lasted for 12 weeks.The improvement situation was observed in the two groups.The visiting hospital frequency during follow up period,Hamilton Anxiety Scale(HAMA14)and Hamilton Depression Scale(HAMD-17)scores in the two groups were compared between before and after treatment.The safety of small dose amitriptyline long term use was observed.Results The effective rates at the end of 4,8,12 weeks in the experimental group were 38.5%,73.8%and 80.0%respectively,which in the control group were 24.6%(P>0.05),45.9%(P<0.05)and 59.0%(P<0.05)respectively.The total visiting hospital times in the experiment group and control group were 2(1,2)and 2(2,3)times(P<0.05).After 12-week treatment,the scores of HAMA-14 and HAMD-17 in the experiment group were significantly decreased compared with entering grouping.No adverse influences on WBC,platelet,liver function,renal function,low density lipoprotein cholesterol,brain natriuretic peptide precursor and blood sugar indexes were found..Conclusion Small dose amitriptyline is safe and effective,significantly improve the clinical symptoms and reduces the visiting hospital times in the patients with untypical chest pain after PCI.
作者
黎东
龚倩
赵亮
戴闽
罗彩东
LI Dong;GONG Qian;ZHAO Liang;DAI Min;Luo Caidong(Department of Cardiology,Mianyang Municipal Central Hospital,Mianyang,Sichuan 621000,China)
出处
《重庆医学》
CAS
2018年第27期3542-3545,共4页
Chongqing medicine
关键词
经皮冠状动脉介入术
胸痛
阿米替林
percutaneous coronary intervention
chest pain
amitriptyline
