摘要
目的探讨地尔硫卓对冠状动脉粥样硬化性心脏病(冠心病)心绞痛患者冠状动脉(冠脉血流储备与血管内皮的影响。方法选自2018年1月至2021年12月于郑州市第七人民医院心脏外科收治的100例冠心病心绞痛患者随机分成对照组(富马酸比索洛尔治疗)与观察组(富马酸比索洛尔+地尔硫卓治疗),每组各50例,均治疗4周。观察两组的心绞痛发生情况(发作次数、疼痛程度、持续时间)、冠脉血流储备(D/R PDV、D/R PSV)、血管内皮指标(内皮素-1、血管内皮生长因子、一氧化氮)、临床疗效以及不良反应(恶心呕吐、头晕头痛、疲倦、失眠、皮疹)。结果观察组患者的心绞痛发作次数、疼痛程度评分、持续时间均低于对照组(P<0.05);两组治疗后的D/R PDV、D/R PSV均较治疗前增加(P<0.05),且观察组治疗后的D/R PDV、D/R PSV均高于对照组(P<0.05);两组治疗后的内皮素-1、血管内皮生长因子均降低(P<0.05),一氧化氮升高(P<0.05),且观察组治疗后的内皮素-1、血管内皮生长因子均低于对照组(P<0.05),一氧化氮高于对照组(P<0.05);观察组总有效率为86.00%,高于对照组的68.00%(P<0.05);两组不良反应发生率比较,无统计学差异(P>0.05)。结论地尔硫卓联合富马酸比索洛尔对冠心病心绞痛的疗效确切,可减少患者心绞痛的发作次数、持续时间,减轻疼痛程度,并能改善冠脉血流储备,减轻血管内皮损伤,有效性与安全性均较好,值得临床应用。
Objective To discuss the influence of diltiazem on coronary flow reserve(CFR)and vascular endothelial function in patients with coronary heart disease and angina pectoris(CHD-AP).Methods CHD-AP patients(n=100)were chosen from Department of Heart Surgery in the Seventh People’s Hospital of Zhengzhou City from Jan.2018 to Dec.2021,ad then randomly divided into control group(treated with bisoprolol fumarate for 4 weeks)and observation group(treated with bisoprolol fumarate+diltiazem for 4 weeks,each n=50).The occurrence of AP(including attack times,pain degree,duration),coronary flow reserve(CFR,including D/R PDV,D/R PSV),vascular endothelial indexes[including endothelin-1(ET-1),vascular endothelial growth factor(VEGF),nitric oxide(NO)],clinical efficacy and adverse reactions(including nausea and vomiting,dizziness,headache,fatigue,insomnia,rash)were observed in 2 groups.Results The attack times,scores of pain degree and duration of AP were lower in observation group than those in control group(P<0.05).After treatment,D/R PDV and D/R PSV increased in 2 groups(P<0.05),and D/R PDV and D/R PSV were higher in observation group than those in control group(P<0.05).ET-1 and VEGF decreased(P<0.05),NO increased(P<0.05)in 2 groups after treatment,and ET-1 and VEGF were lower(P<0.05)and NO was higher(P<0.05)in observation group than those in control group.The total effective rate was 86.00%in observation group and 68.00%in control group(P<0.05).The comparison in adverse reaction incidence showed no statistical difference between 2 groups(P>0.05).Conclusion Diltiazem combined with bisoprolol fumarate has reliable curative effect on CHD-AP,and can reduce attack times,duration and pain degree of AP,improve CFR and relieve vascular endothelial injury.Diltiazem combined with bisoprolol fumarate has higher effectiveness and safety and is worth clinical administration.
作者
张富山
张宇
蔡俊
黄建领
赵俊涛
刘广文
张伟峰
Zhang Fushan;Zhang Yu;Cai Jun;Huang Jianling;Zhao Juntao;Liu Guangwen;Zhang Weifeng(Department of Heart Surgery,Seventh People's Hospital of Zhengzhou City,Zhengzhou 450000,China;不详)
出处
《中国循证心血管医学杂志》
2023年第3期325-328,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
地尔硫卓
冠心病
心绞痛
冠脉血流储备
血管内皮
Diltiazem
Coronary heart disease
Angina pectoris
Coronary flow reserve
Vascular endothelial function
