地爾硫緩解PCI術(shù)后心絞痛的臨床療效觀察

周琦，史玲，潘云紅，王瑩

心血管病研究

周琦，史玲，潘云紅，王瑩

1 資料與方法

1.3 觀察指標(biāo) (1)心絞痛發(fā)作次數(shù)，每次發(fā)作時(shí)間；(2)術(shù)前及術(shù)后0h、24h、14d、3個(gè)月的血壓、心率、心肌耗氧量(心率×收縮壓)、C反應(yīng)蛋白(CRP)；(3)3個(gè)月后行超聲心動(dòng)圖(Acuson公司產(chǎn)Sequoia512型彩色多普勒超聲診斷儀)檢查左室射血分?jǐn)?shù)(LVEF)及左室短軸縮短率(LVFS)；(4)不良反應(yīng)。

2 結(jié) 果

2.1 心絞痛比較 治療前2組心絞痛發(fā)作次數(shù)和持續(xù)時(shí)間比較無(wú)明顯差異(P﹥0.05)，與治療前比較，治療后2組均顯著改善(P<0.05)，且治療組顯著低于對(duì)照組(P<0.05)。見(jiàn)表1。

表1 2組患者心絞痛發(fā)作次數(shù)和持續(xù)時(shí)間比較

注：與治療前比較，*P<0.05；與對(duì)照組治療后比較，#P<0.05

2.2 血壓、心率、心肌氧耗量、CRP比較 與術(shù)前比較，2組血壓、心率、心肌氧耗量和CRP水平在術(shù)后0h均有所升高(P<0.05)。治療組收縮壓、舒張壓、心率、心肌耗氧量和CRP水平在術(shù)后24h、14d、3個(gè)月明顯低于對(duì)照組，差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。見(jiàn)表2。

2.3 超聲心動(dòng)圖指標(biāo)比較 2組3個(gè)月后LVEF與LVFS均較治療前明顯升高，且治療組較對(duì)照組升高更顯著，差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。見(jiàn)表3。

表3 2組超聲心電圖指標(biāo)比較

注：與治療前比較，*P<0.05；與對(duì)照組治療后比較,#P<0.05

2.4 不良反應(yīng) 2組治療后均無(wú)明顯不良反應(yīng)如緩慢性心律失常、低血壓及心功能惡化，無(wú)心力衰竭、休克、過(guò)敏、精神神經(jīng)異常、面部潮紅等不良反應(yīng)。治療結(jié)束時(shí)三大常規(guī)、血糖、血脂、肝腎功能與治療前比較均無(wú)明顯變化。

3 討 論

表2 2組術(shù)前、術(shù)后各時(shí)間點(diǎn)血壓、心率、心肌耗氧量和CRP變化情況

注：與治療前比較，*P<0.05；與對(duì)照組治療后同時(shí)點(diǎn)比較,#P<0.05

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Thetherapeuticeffectofdiltiazemonanginaafterpercutaneouscoronaryintervention

ZHOUQi,SHILing,PANYunhong,WANGYing.

DepartmentofCardiology,WuhanUniversityAffiliatedTianyouHospital,Wuhan431000,China

ObjectiveTo detect the therapeutic effect of diltiazem on angina after percutaneous coronary intervention (PCI).MethodsA total of 180patients after PCI with coronary atherosclerotic heart disease were enrolledin this analysis. All or the patients were randomly dividedinto diltiazem therapy group (102 patients) andnon diltiazem therapy control group (78 patients). We comparedthe frequency andthe duration of angina, the bloodpressure, heart rate, myocardial oxygen consumption, C reactive protein (CRP), left ventricular function (LVEF) andleft ventricular fractional shortening (LVFS) before andafter PCI on 0h, 24h, 14days and3months between the two groups.ResultsThe frequency andthe duration of angina in the therapy group were significantly lower than the control group. The systolic bloodpressure, diastolic bloodpressure, heart rate, myocardial oxygen consumption, andthe CRP in the diltiazem therapy group were significantly lower than the control group at 0h, 24h, 14days and3months after PCI, andthe levels of LVEF andLVFS were significantly higher than the control group (P<0.05). Both two groups hadno adverse reaction.ConclusionDiltiazem can significantly relieve the angina after PCI andimprove the ventricular function, it is worth to use in clinical practice.

Diltiazem; Percutaneous coronary intervention ; Angina pectoris

431000 武漢科技大學(xué)附屬天佑醫(yī)院心血管內(nèi)科

10.3969 / j.issn.1671-6450.2014.01.005

2013-07-03)