尼可地尔联合二丁酰环磷酰苷钙对高原地区冠心病合并心力衰竭患者的疗效评估

目的观察尼可地尔联合二丁酰环磷酸苷钙对高原地区冠状动脉粥样硬化性心脏病(简称冠心病)合并心力衰竭患者的疗效。方法选取2018年1-12月该院治疗的高原地区冠心病合并心力衰竭患者106例,按照随机数字表法分为对照组和观察组,每组53例。对照组给予尼可地尔片,观察组在对照组基础上给予二丁酰环磷酸苷钙。两组患者均治疗2个月,比较两组患者疗效、6min步行试验(6-MWD)、心功能指标左心室收缩末期内径(LVESD)、左心室射血分数(LVEF%)、左心室舒张末期内径(LVEDD)及每分钟排血量(CO)]、心肌营养素-1(CT-1)、β-内啡肽(β-EP)及不良反应发生率。结果观察组的有效率为92.45%,明显高于对照组的77.36%(χ^2=4.710,P=0.030)。治疗前,两组患者6-MWD、LVESD、LVEDD、LVEF%、CO、CT-1及β-EP差异无统计学意义(P>0.05)。治疗2周后,观察组患者CT-1、β-EP、LVESD、LVEDD低于对照组(t=9.915、9.772、9.753、15.261,均P=0.000);观察组的LVEF%及CO高于对照组(t=9.753、15.261,均P=0.000)。观察组和对照组不良反应发生率分别为3.33%和5.00%(χ^2=0.210,P=0.648)。结论尼可地尔联合二丁酰环磷酸苷钙治疗高原地区冠心病合并心力衰竭具有良好的临床疗效,可显著改善患者心功能,安全性高。

Efficacy evaluation of nicorand combined with dibutyryl cyclophosphonate in patients with coronary heart disease complicated with heart failure in high altitude area

Objective To observe the effect of nicorandil combined with dibutyryl cyclophosphate calcium on coronary atherosclerotic heart disease(referred to as coronary heart disease)complicated with heart failure at high altitude.Methods From January 2018 to December 2018,106 patients with coronary heart disease complicated with heart failure were divided into control group and observation group with 53 cases in each group.The control group was given nicorandil tablets and the observation group was given calcium dibutyryl cyclophosphate on the basis of the control group.Both groups of patients were treated for 2 months,the efficacy of the two groups,6 min walking test(6-MWD),cardiac functionleft ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF%),left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection volumeper minute(CO)],cardiotrophin-1(CT-1),β-endorphin(β-EP),and incidence of adverse reactions were compared between the two groups.Results The effective rate in the observation group was 92.45%,which was significantly higher than the 77.36%in the control group(χ^2=4.710,P=0.030).Before treatment,there was no significant difference in 6-MWD,LVESD,LVEDD,LVEF%,CO,CT-1 andβ-EP between the two groups(P>0.05).After 2 weeks of treatment,CT-1,β-EP,LVESD,and LVEDD of the observation group were lower than those of the control group(t=9.915,9.772,9.753,15.261,all P =0.000);LVEF%and CO of the observation group were higher than the control Group(t=9.753,15.261,all P =0.000).The incidence of adverse reactions in the observation group and the control group was 3.33% and5.00%,respectively(χ^2=0.210,P=0.648).Conclusion Nicorandil combined with dibutyryl cyclophosphate calcium has a good clinical effect in the treatment of coronary heart disease complicated with heart failure in high altitude area and can significantly improve the heart function of patients with high safety.