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目的:观察静脉应用地尔硫联合硝酸甘油对高龄患者冠脉三支病变导致不稳定性心绞痛的临床疗效和安全性,以促进其安全合理应用。方法:选择100例75～85岁冠脉三支病变所致不稳定性心绞痛患者,随机分为治疗组和对照组,每组各50例患者。治疗组在常规治疗基础上静脉给予地尔硫2μg·min-1·kg-1联合硝酸甘油0.1μg·min-1·kg-1,对照组在常规治疗基础上静脉给予硝酸甘油0.1μg·min-1·kg-1,两组均24h持续微量泵入,对两组患者的疗效和不良反应进行比较分析。结果:治疗组平均心绞痛发作次数显著减少,平均心绞痛最长时间显著缩短,室性恶性心律失常发生次数明显减少,心电图缺血性表现显著改善;但是相关不良反应有增多趋势。结论:静脉应用地尔硫联合硝酸甘油对高龄冠脉三支病变不稳定心绞痛疗效确切,但可能出现不良反应,应予以注意。
Objective: To observe the clinical efficacy and safety of intravenous diltiazem combined with nitroglycerin in the treatment of coronary heart disease and coronary heart disease in elderly patients with unstable angina pectoris, so as to promote its safe and rational use. Methods: One hundred patients with unstable angina pectoris caused by three coronary lesions of 75-85 years old were selected and randomly divided into treatment group and control group, with 50 patients in each group. In the treatment group, diltiazem 2μg · min-1 · kg-1 and nitroglycerin 0.1μg · min-1 · kg-1 were given intravenously on the basis of routine treatment. The control group was given intravenous nitroglycerin 0.1μg · min-1 · kg-1, both groups were 24h continuous micro-pump, the two groups of patients with efficacy and adverse reactions were compared. Results: In the treatment group, the average number of angina attacks was significantly reduced, the longest mean angina pectoris time was significantly shortened, the number of ventricular arrhythmia was significantly reduced, and the ECG ischemic performance was significantly improved. However, the incidence of adverse reactions increased. Conclusion: Intravenous Diltiazem combined with nitroglycerin has definite curative effect on unstable angina pectoris in elderly patients with coronary artery disease. However, adverse reactions may occur and should be paid attention to.