尼可地尔与曲美他嗪对冠脉介入术后再发心绞痛患者的影响

目的观察尼可地尔(Nicorandil)及曲美他嗪(Trimetazidine)对行经皮冠状动脉介入(PCI)治疗术后再发心绞痛患者的影响。方法按入选标准,随机连续选入邢台市第三医院自2009年10月—2011年7月曾于邢台市第三医院接受PCI手术,术后仍有心绞痛的患者150例,且随机将患者分为2组:尼可地尔组和曲美他嗪组,每组各75例。两组均在PCI术后常规使用二级预防药物,尼可地尔组在常规治疗基础上加用尼可地尔10 mg,口服3次/d,曲美他嗪组在常规治疗基础上加用曲美他嗪20 mg口服,3次/d。观察患者服药3个月内发生心绞痛的例数、心绞痛发作次数及持续时间、心绞痛的分级和主要心血管不良事件(Mace)发生率。并观察服药前及服药3个月时左室射血分数(LVEF)。结果在心绞痛发作例数、发作次数及心绞痛加拿大心血管学会(CCS)]Ⅲ级等方面尼可地尔组优于曲美他嗪组,差异有统计学意义(P0.05)。在主要心血管Mace发生率方面,尼可地尔组略低于曲美他嗪组,但两者之间差异无统计学意义(P0.05)。治疗3个月后尼可地尔组及曲美他嗪组LVEF较自身改善,差异有统计学意义(P0.05);尼可地尔组略高于曲美他嗪组,但两者差异无统计学意义(P0.05)。结论 PCI术后再发心绞痛的患者在常规治疗基础上加用尼可地尔或曲美他嗪可有效减少心绞痛发作次数,改善患者左心功能,在缓解心绞痛方面尼可地尔优于曲美他嗪。

Influence of Nicorandil and Trimetazidine on patients with recurrence of angina pectoris after percutaneous coronary intervention

Objective]To observe the therapeutic effect of Nicorandil and Trimetazidine on patients with recurrence of angina pectoris after percutaneous coronary intervention(PCI). Methods]According to the criteria,150 patients were randomly and continuously collected from the Third Hospital of Xingtai City from October 2009 to July 2011,all patients received PCI and still had angina,and they were randomly divided into the Nicorandil group(75 cases) and the Trimetazidine group(75 cases).Two groups were given conventional secondary prevention drugs after PCI.On the basis of routine treatment,the Nicorandil group was treated with Nicorandil 10 mg by oral Administration,three times daily,and the Trimetazidine group was treated with Trimetazidine 20 mg by oral Administration,three times daily.The case numbers of angina pectoris,times and duration of angina attacks,classification of angina pectoris and the incidence rate of main adverse cardiovascular events(Mace) of patients within three months were observed.The Left ventricular ejection fraction(LVEF) of patients before medication and three months after medication were observed. Results]The case numbers of angina pectoris,times of angina attacks and incidence rate of Ⅲ level angina pectoris(Canadian Cardiovascular Society) in the Nicorandil group were lower than those in the Trimetazidine group,the difference were significant(P<0.05).The incidence rate of Mace in the Nicorandil group was lower than that in the Trimetazidine group,but the difference was not significant(P>0.05).After three months of medication,the LVEF of the Nicorandil group and Nicorandil group had improved as compared with that before medication.After three months of medication,the LVEF of Nicorandil group was slightly higher than that of the Trimetazidine group,but the difference was not significant(P>0.05). Conclusion]On the basis of routine treatment,Nicorandil or Trimetazidine can reduce the times of heart attacks and improve the left ventricular function in patients with recurrence of angina pectoris after PCI.The effect of Nicorandil is better than that of Trimetazidine in alleviating angina pectoris.