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不同剂量替罗非班联合地尔硫卓对高危不稳定型心绞痛近期和远期预后的影响

Effects of different doses of tirofiban combined with diltiazem on long-term and short-term prognosis of high-risk unstable angina pectoris

    摘要
  • 摘要:
    目的 探讨不同剂量替罗非班联合地尔硫卓对高危不稳定型心绞痛(UAP)近期和远期预后的影响。
    方法 随机选取心绞痛患者100例，根据治疗方法不同分为观察组50例和对照组50例。对照组选用常规剂量替罗非班联合地尔硫卓治疗，观察组给予小剂量替罗非班联合地尔硫卓治疗。比较2组不良反应、血液流变学指标、血脂水平总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、心功能指标脑钠肽(BNP)、左室射血分数(LVEF)及随访6个月后心绞痛发作情况。
    结果 治疗后, 2组血清TC、TG、LDL-C、血浆黏度、红细胞压积、红细胞沉降率、BNP水平均低于治疗前, HDL-C、LVEF水平均高于治疗前，差异有统计学意义(P < 0.05); 治疗后，与对照组比较，观察组患者血清TC、TG、LDL-C、血浆黏度、红细胞压积、红细胞沉降率、BNP水平较低, HDL-C、LVEF水平较高，差异有统计学意义(P < 0.05); 6个月后, 2组患者心绞痛持续时间缩短，发作次数减少，且观察组心绞痛持续时间短于对照组，发作次数少于对照组，差异均有统计学意义(P < 0.05); 治疗后，观察组不良反应总发生率(4.00%)低于对照组(16.00%), 差异有统计学意义(P < 0.05)。
    结论 小剂量替罗非班联合地尔硫卓可提升高危UAP患者的心功能，减少心绞痛次数，减轻疼痛程度，有效调节血脂水平，改善血液流变学。

     

    Abstract:
    Objective To investigate effects of different doses of tirofiban combined with diltiazem on long-term and short-term prognosis of high-risk unstable angina pectoris(UAP).
    Methods A total of 100 patients with angina pectoris were randomly selected and divided into observation group (n=50) and control group (n=50) according to different treatment methods. The control group was treated with conventional dose of tirofiban combined with diltiazem, and the observation group was treated with low dose tirofiban combined with diltiazem. Occurrence of adverse reactions, hemorheology, blood lipid levelstotal cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and heart function indexesbrain sodium peptide(BNP), left ventricular ejection fraction (LVEF) and angina pectoris attack after 6 months of follow-up were compared.
    Results After treatment, the serum TC, TG, LDL-C, plasma viscosity, hematokrit, erythrocyte sedimentation rate and BNP levels in both groups were lower than those before treatment, and the levels of HDL-C and LVEF were higher than before treatment (P < 0.05); compared with the control group, the serum TC, TG, LDL-C, plasma viscosity, hematokrit, red blood cell sedimentation rate, and BNP level in the observation group were lower, and HDL-C and LVEF levels were higher after treatment (P < 0.05); after 6 months, the duration of angina pectoris was shorter, and the number of episodes was decreased in both groups (P < 0.05); the duration of angina pectoris in the observation group was shorter than that of control group, and the number of attacks was less than that in the control group(P < 0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group (16.00% versus 4.00%, P < 0.05).
    Conclusion Low-dose tirofiban combined with diltiazem can improve cardiac function of high-risk UAP patients, reduce the frequency of angina pectoris, effectively regulate blood lipid levels and improve hemorheology.

     

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