2018 年第 12 期 第 13 卷

尼可地尔对高龄2型糖尿病合并不稳定型心绞痛患者的疗效研究

Therapeutic effect of nicorandil on advanced age patients with type 2 diabetes mellitus and unstable angina pectoris

作者：刘虹宏刘兆川张京梅林运

英文作者：

单位：100029首都医科大学附属北京安贞医院心内科十五病房（刘虹宏、张京梅、林运）；073000河北省保定市，陆军第82集团军医院心内科（刘兆川）

英文单位：

关键词：不稳定型心绞痛；2型糖尿病；尼可地尔

英文关键词：

• 摘要：

• 【摘要】目的    观察尼可地尔对高龄2型糖尿病合并不稳定型心绞痛患者的疗效。方法    选取2016年4月至2017年3月在首都医科大学附属北京安贞医院住院的高龄2型糖尿病合并不稳定型心绞痛患者82例，按照随机数字表法分为对照组（42例）和尼可地尔组（40例）。对照组控制血糖达标，给予冠状动脉粥样硬化性心脏病标准二级预防治疗方案；尼可地尔组在对照组治疗基础上口服尼可地尔片；2组均连续治疗3个月。比较2组治疗后心绞痛和心电图改善效果、血清学指标（天冬氨酸转氨酶、血肌酐、C反应蛋白）和不良反应发生情况。结果    治疗后，尼可地尔组心绞痛和心电图总有效率均明显高于对照组［90.0%(36/40)比71.4%(30/42)、92.5%(37/40)比78.6%(33/42)］，差异均有统计学意义（均P＜0.05）。治疗前，2组患者天冬氨酸转氨酶、血肌酐、C反应蛋白水平比较，差异均无统计学意义（均P＞0.05）。治疗后，2组患者天冬氨酸转氨酶、血肌酐与治疗前及组间比较，差异均无统计学意义（均P＞0.05）。治疗后，2组C反应蛋白水平均明显低于治疗前［对照组：（10.5±3.3）mg/L比（13.5±2.4）mg/L；尼可地尔组：（6.8±2.3）mg/L比（12.7±2.4）mg/L］，且尼可地尔组明显低于对照组，差异均有统计学意义（均P＜0.05）。2组治疗过程中均未出现肝肾功能损伤，对照组4例、尼可地尔组3例出现头胀、头痛，均停服单硝酸异山梨酯片后缓解。结论    尼可地尔对高龄2型糖尿病合并不稳定型心绞痛患者心绞痛和心电图具有较好疗效，且安全性较好。

• 【Abstract】Objective    To investigate the effect of nicorandil on type 2 diabetes mellitus complicated with unstable angina pectoris in advanced age patients. Methods    From April 2016 to March 2017, 82 elderly patients with type 2 diabetes mellitus complicated with unstable angina pectoris hospitalized in Beijing Anzhen Hospital, Capital Medical University were randomly divided into control group(42 cases) and nicorandil group(40 cases). The control group was given standard secondary prevention and treatment of coronary heart disease. The nicorandil group took nicorandil tablets on the basis of routine treatment. Both groups were treated continuously for 3 months. Improvement of angina pectoris, changes of electrocardiogram, serum indexes and adverse reactions were analyzed. Results    After treatment, the total effective rates of angina pectoris and electrocardiogram in the nicorandil group were significantly higher than those in the control group［90.0%(36/40) vs 71.4%(30/42), 92.5%(37/40)vs 78.6%(33/42)］（P＜0.05）. There was no significant difference of aspartate aminotransferase（AST）, serum creatinine（Scr） and C-reactive protein（CRP） levels between groups before treatment(P＞0.05). After treatment, AST and Scr levels were similar between groups(P＞0.05); the level of CRP in both the control group and nicorandil group were significantly lower than those before treatment［（10.5±3.3）mg/L vs（13.5±2.4）mg/L；（6.8±2.3）mg/L vs（12.7±2.4）mg/L］ and there was a significant difference between the two groups(P＜0.05). No liver and kidney function injury was observed. Headache and distention occurred in 4 cases in the control group and 3 cases in the nicorandil group; all patients were relieved after discontinuing isosorbide mononitrate tablets. Conclusion    Nicorandil is effective and safe in the treatment of type 2 diabetes mellitus complicated with unstable angina pectoris in elderly patients.