运动平板试验对尼可地尔治疗冠心病心绞痛的效果评价

摘要

目的 探讨运动平板试验(TET)对尼可地尔治疗冠心病心绞痛的效果评价.方法 选取冠心病心绞痛且运动平板试验阳性患者80例,根据治疗方法不同随机分为观察组和对照组各40例.两组均予美托洛尔、钙离子拮抗剂等常规治疗,在此基础上观察组联合尼可地尔治疗,对照组联合硝酸甘油治疗,均连用4周.比较两组患者治疗后TET疗效、TET阳性率、运动终止时诱发心绞痛发生率及治疗前后TET各项参数.结果 治疗后,两组达最大负荷量时心率、运动ST段压低值分别较治疗前显著降低,而运动负荷量、代谢当量(METS)、平均运动时间较治疗前显著增加(P均<0.05),且观察组患者的达最大负荷量时心率、运动负荷量、METS、平均运动时间、运动ST段压低值较对照组改善更显著(P均<0.05).治疗后,两组患者TET疗效评价结果显示,观察组的总有效率(95.0％)高于对照组(75.0％)(P<0.05).观察组TET阳性率(52.5％)及运动终止时诱发心绞痛发生率(15.0％)均低于对照组(80.0％、32.5％)(P均<0.05).结论 通过TET证实尼可地尔治疗冠心病心绞痛疗效确切,可以显著改善患者的心肌缺血状态,安全性较好.%Objective Using the treadmill exercise test ( TET) to evaluate the effect of nicorandil in treatment of an-gina pectoris in coronary heart disease ( CHD) .Methods Eighty patients with angina pectoris in CHD and positive TET were randomly divided into the observation group and control groups according to different treatment methods , with 40 in each.Both groups received the conventional treatment (metoprolol, calcium antagonists, etc.), besides the observation group was treated with nicorandil , and the control group was treated with nitroglycerin , for 4 weeks .The TET curative effect, the TET positive rate, the induced angina pectoris rate at the termination of TET , and the TET parameters before and after treatment were compared between the two groups .Results After treatment , the heart rate and the ST-segment de-pression of the two groups at the maximum load were significantly lower than those before treatment , while the exercise load, metabolic equivalent (METS), and mean exercise time significantly increased (all P<0.05);the heart rate, exer-cise load, METS, mean exercise time, and ST-segment depression in the observation group at the maximum load improved more significantly than those in the control group (all P<0.05).After treatment, TET results showed that the total effec-tive rate in the observation group was 95.0％, which was significantly higher than that in the control group (75.0％);both the TET positive rate (52.5％) and the induced angina pectoris rate at the termination of TET (15.0％) of the observation group were lower than those of the control group (80.0％, 32.5％), respectively;the difference was statistically signifi-cant (all P<0.05).Conclusion TET confirms that the curative effect of nicorandil in treatment of angina pectoris is ex -act, and nicorandil can significantly improve myocardial ischemia of patients with good security .