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目的观察慢性完全闭塞(CTO)病变介入术后联合使用尼可地尔和复方丹参滴丸的疗效。方法多中心、随机、单盲法连续入选2014年6月-2016年9月入院的CTO病变行介入治疗的患者80例,随机分为试验组和对照组各40例,术后2组患者均根据病情选用抗血小板药物、他汀类药物、ACEI或ARB类药物、β受体阻滞药等治疗,试验组在常规治疗基础上加上尼可地尔5 mg,3次/日,复方丹参滴丸10粒,3次/日,监测术后心绞痛发作次数,PCI术后1年行超声心动图检查,记录左室射血分数(LVEF),记录PCI术后1年内主要不良心脏事件(MACE)。结果试验组心绞痛发作次数少于对照组,每次心绞痛发作持续时间短于对照组,差异均有统计学意义(P<0.05)。试验组总有效率为82.5%(33/40)高于对照组的62.5%(24/40),差异有统计学意义(P<0.05)。治疗1年后心脏超声检查,试验组的EF明显高于对照组,随访1年中,试验组急性冠脉事件发生率低于对照组,差异均有统计学意义(P<0.05)。结论 CTO病变介入术后联合使用尼可地尔和复方丹参滴丸,可明显减少心绞痛发作次数,改善心肌微循环灌注,保护左心室功能、减少MACE事件发生。
Objective To observe the curative effect of combination of nicorandil and compound Danshen dripping pills after the intervention of chronic total occlusion (CTO). Methods A total of 80 consecutive patients who underwent CTO in our hospital from June 2014 to September 2016 were randomly divided into trial group and control group with 40 cases in each group. All patients in 2 groups According to the condition, anti-platelet drugs, statins, ACEI or ARB drugs and β-blockers were used. The experimental group was treated with Nicorandil 5 mg 3 times a day on the basis of routine treatment, 10 pills, 3 times a day, the number of angina pectoris episodes were monitored. Echocardiography was performed one year after PCI. The left ventricular ejection fraction (LVEF) was recorded. The major adverse cardiac events (MACEs) within 1 year after PCI were recorded. . Results The number of angina attacks in the experimental group was less than that in the control group, and the duration of each angina attack was shorter than that in the control group (P <0.05). The total effective rate was 82.5% (33/40) in the experimental group and 62.5% (24/40) in the control group, with significant difference (P <0.05). After 1 year of treatment, the echocardiographic examination showed that the EF in the experimental group was significantly higher than that in the control group. The incidence of acute coronary events in the experimental group was lower than that in the control group at one year follow-up (P <0.05). Conclusions Combination of Nicorandil and Danshen Dripping Pill after CTO lesion can significantly reduce the number of angina attacks, improve myocardial perfusion, protect left ventricular function and reduce the occurrence of MACE.