关键词:

冠心病, 心绞痛, 胺碘酮, 尼可地尔, 疗效

Abstract:

Objective　To investigate the efficacy of nicorandil combined with amiodarone in the treatment of coronary heart disease with angina pectoris. Methods　The clinical data of 120 patients with coronary heart disease and angina pectoris admitted to the First People's Hospital of Nanyang City from April 2022 to April 2024 were collected for a retrospective study. They were divided into a reference group (61 cases) and a study group (59 cases) according to different treatment plans. In the reference group, there were 33 males and 28 females, aged (56.02±7.52) years, the course of disease was (3.25±0.63) years, and the grading of cardiac function was as follows: 16 cases of grade I, 35 cases of grade II, and 10 cases of grade III. In the study group, there were 35 males and 24 females, aged (57.96±7.46) years, the course of disease was (3.50±0.82) years, and the grading of cardiac function was as follows: 15 cases of grade I, 33 cases of grade II, and 11 cases of grade III. The reference group was treated with oral nicorandil tablets, 5 mg/time, 3 times/day. The study group was given amiodarone injection intravenously on the basis of the reference group, and 150 mg of amiodarone injection was dissolved in 20 ml of normal saline, amiodarone injection was injected slowly for 20 min, then at the rate of 1 mg/min for 6 h, and then gradually reduced to 0.5 mg/min, with the total amount within 24 h less than 2 000 mg; after the heart rate recovered, amiodarone tablets were taken orally, 0.2 g/time, twice a day. Both groups were treated for 4 weeks. The clinical symptoms, cardiac function indicators, and serum levels of relevant cytokines [hypersensitive C-reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2)] before and after treatment and the total incidence of adverse reactions were compared between the two groups. χ² test and t test were used for statistical analysis. Results　After treatment, the frequency of angina pectoris in the study group was less than that in the reference group, and the duration of angina pectoris attacks was shorter [(1.02±0.28) times/week vs. (2.37±0.61) times/week, (2.77±0.92) min/time vs. (4.01±0.85) min/time]; the left ventricular end-systolic diameter was smaller than that in the reference group, and the left ventricular ejection fraction was higher than that in the reference group [(32.88±3.41) mm vs. (39.73±3.27) mm, (50.25±3.04)% vs. (48.12±3.15)%]; the levels of hs-CRP and Lp-PLA2 were lower than those in the reference group [(5.32±1.14) mg/L vs. (10.75±1.03) mg/L, (20.76±3.96) µg/L vs. (35.24±4.35) µg/L], with statistically significant differences (t=-15.664, -7.662, -11.225, 3.769, -27.349, and -19.079, all P<0.001). The total incidence of adverse reactions in the study group was slightly higher than that in the reference group [8.20% (5/61) vs. 5.08% (3/59)], but the difference was not statistically significant (χ²=0.467, P=0.494). Conclusion　Nicorandil combined with amiodarone can effectively alleviate the clinical symptoms, inhibit the inflammatory reactions, maintain the plaque stability, improve the cardiac function, and has high safety in patients with coronary heart disease and angina pectoris.

Key words:

Coronary heart disease, Angina pectoris, Amiodarone, Nicorandil, Curative effect