1例不稳定型心绞痛患者的药学监护

1例78岁女性患者,因不稳定型心绞痛入院治疗,入院时合并有高血压病和2型糖尿病。给予扩张冠状动脉、抗血小板、降压等治疗,并于入院第3天行经皮冠状动脉介入治疗,术后患者情况稳定。针对患者心绞痛发病时舌下含服硝酸甘油症状不能缓解,高血压药物控制血压效果不佳,行乙醛脱氢酶(ALDH)和高血压药物相关基因检测,作为选用和调整药物依据。患者ALDH为WM(GA)型(低活性),其含服硝酸甘油效果差,不能作为急性心绞痛的治疗药,必要时含服速效救心丸;高血压药物相关基因检测显示,患者对β受体阻滞剂的代谢酶活性低,对ACE抑制剂(ACEI)和AT1受体阻断药(ARBs)敏感,可根据具体情况加以选择。经合理优化治疗方案,患者血压及血糖控制稳定,病情好转出院。

Pharmaceutical care on a patient with instable angina

One 78-year-old woman with instable angina,hypertension and type II diabetes was hospitalized for acute coronary syndrome and received the therapy of distending the coronary artery,anti-platelet,lowering hypertension,etc.Three days later,the patient was treated with the therapy of PCI,and then the situation was stable.Considering the oral nitroglycerin having no effect on the patient,and the hypertension didn't control very well,the hypertension related gene(HRG) was detected.The results showed that the gen...