尼可地尔治疗慢性缺血性心肌病致心力衰竭患者的效果观察
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摘要
目的观察尼可地尔治疗慢性缺血性心肌病致心力衰竭患者的临床效果。方法选取医院总部心内科门诊及住院诊治的慢性缺血性心肌病致心力衰竭患者87例为研究对象,随机分为观察组44例和对照组43例。对照组予以常规治疗,观察组在常规治疗基础上加用尼可地尔治疗。随访治疗8个月,比较2组心功能情况、临床疗效、不良事件发生情况。结果治疗前,2组左心室射血分数(LVEF)、左心室收缩末内径(LVESD)、左心室舒张末内径(LVEDD)比较差异均无统计学意义(P> 0. 05);治疗后,2组LVEF较治疗前升高,LVESD、LVEDD较治疗前降低,且观察组升高或降低幅度大于对照组(P均<0. 01);观察组治疗总有效率为95. 45%,高于对照组的79. 07%(P <0. 05);观察组不良事件发生率为6. 82%,低于对照组的23. 26%(P <0. 05)。结论在常规治疗的基础上加用尼可地尔治疗,可改善慢性缺血性心肌病致心力衰竭患者的心功能,且可减少心绞痛及心律失常的发生。
Objective To observe the clinical effect of nicorandil on heart failure caused by chronic ischemic cardiomyopathy. Methods 87 patients with heart failure caused by chronic ischemic cardiomyopathy were randomly divided into observation group( 44 cases) and control group( 43 cases). The control group was given routine treatment,while the observation group was treated with nicorandil on the basis of routine treatment. Heart function,clinical efficacy and adverse events were compared between the two groups after 8 months of follow-up. Results Before treatment,there was no significant difference in LVEF,LVESD and LVEDD between the two groups( P > 0. 05). After treatment,LVEF in the two groups increased and LVESD and LVEDD decreased,and the increase or decrease in the observation group was greater than that in the control group( P < 0. 01). The total effective rate of the observation group was 95. 45%,higher than 79. 07% of the control group( P < 0. 05). The incidence of adverse events was 6. 82% in the observation group,which was lower than 23. 26% in the control group( P < 0. 05). Conclusion On the basis of routine treatment,nicorandil can improve the cardiac function of patients with heart failure caused by chronic ischemic cardiomyopathy and reduce the incidence of adverse events such as angina pectoris and arrhythmia,which is worthy of clinical application.
Objective To observe the clinical effect of nicorandil on heart failure caused by chronic ischemic cardiomyopathy. Methods 87 patients with heart failure caused by chronic ischemic cardiomyopathy were randomly divided into observation group( 44 cases) and control group( 43 cases). The control group was given routine treatment,while the observation group was treated with nicorandil on the basis of routine treatment. Heart function,clinical efficacy and adverse events were compared between the two groups after 8 months of follow-up. Results Before treatment,there was no significant difference in LVEF,LVESD and LVEDD between the two groups( P > 0. 05). After treatment,LVEF in the two groups increased and LVESD and LVEDD decreased,and the increase or decrease in the observation group was greater than that in the control group( P < 0. 01). The total effective rate of the observation group was 95. 45%,higher than 79. 07% of the control group( P < 0. 05). The incidence of adverse events was 6. 82% in the observation group,which was lower than 23. 26% in the control group( P < 0. 05). Conclusion On the basis of routine treatment,nicorandil can improve the cardiac function of patients with heart failure caused by chronic ischemic cardiomyopathy and reduce the incidence of adverse events such as angina pectoris and arrhythmia,which is worthy of clinical application.
引文
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[7]Afzal MZ,Reiter M,Gastonguay C,et al.Nicorandil,a nitric oxide donor and ATP-sensitive potassium channel opener,pro tects against dystrophin-deficient cardiomyopathy[J].Journal of Cardiovascular Pharmacology&Therapeutics,2016,21(6):549-562.
[8]朱长祝,何九龙.尼可地尔治疗缺血性心肌病对心功能的影响[J].中西医结合心血管病电子杂志,2014,2(11):18-19.
[9]Fukui Y,Nozawa T,Ihori H,et al.Nicorandil attenuates ischemiareperfusion injury Via inhibition of norepinephrine release from cardiac sympathetic nerve terminals[J].International Heart Journal,2017,58(5):787-793.
[10]Sizova ZM,Zakharova VL,Kozlova NV,et al.Influence of the potassium channels activator nicorandil to the quality of life in patients with ishemic heart disease and stable angina pectoris[J].Kardiologiia,2016,56(6):26.
[11]Wang YP,Zhang Y,Sun YR,et al.Effect of nicorandil on ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction underwent emergent percutaneous coronary intervention treatment[J].Zhonghua Xin Xue GuanBing Za Zhi,2017,45(8):701-705.
[2]王强,杨晓宇.尼可地尔对缺血性心肌病心力衰竭患者血清CPP、GDF-15表达的影响[J].泰山医学院学报,2018,39(11):1254.
[3]张殿福.尼可地尔治疗冠心病慢性心力衰竭的疗效观察[J].河北医药,2013,35(19):2921-2922.DOI:10.3969/j.issn.1002-7386.2013.19.018.
[4]姚峰,刘波,刘敏,等.尼可地尔治疗慢性缺血性心肌病患者心力衰竭的临床疗效观察[J].中国临床医生杂志,2016,44(1):30-32.DOI:10.3969/j.issn.2095-8552.2016.01.012.
[5]陈航,张育民,李峰.尼可地尔对慢性稳定性冠心病患者经皮冠状动脉介入治疗术术后血管内皮功能及炎症反应的影响[J].中南药学,2015,13(1):108-112.
[6]李传威,孙志军,杨波,等.尼可地尔在缺血性心脏病患者中的疗效研究[J].中国循证心血管医学杂志,2016,8(4):425-427.
[7]Afzal MZ,Reiter M,Gastonguay C,et al.Nicorandil,a nitric oxide donor and ATP-sensitive potassium channel opener,pro tects against dystrophin-deficient cardiomyopathy[J].Journal of Cardiovascular Pharmacology&Therapeutics,2016,21(6):549-562.
[8]朱长祝,何九龙.尼可地尔治疗缺血性心肌病对心功能的影响[J].中西医结合心血管病电子杂志,2014,2(11):18-19.
[9]Fukui Y,Nozawa T,Ihori H,et al.Nicorandil attenuates ischemiareperfusion injury Via inhibition of norepinephrine release from cardiac sympathetic nerve terminals[J].International Heart Journal,2017,58(5):787-793.
[10]Sizova ZM,Zakharova VL,Kozlova NV,et al.Influence of the potassium channels activator nicorandil to the quality of life in patients with ishemic heart disease and stable angina pectoris[J].Kardiologiia,2016,56(6):26.
[11]Wang YP,Zhang Y,Sun YR,et al.Effect of nicorandil on ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction underwent emergent percutaneous coronary intervention treatment[J].Zhonghua Xin Xue GuanBing Za Zhi,2017,45(8):701-705.