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目的:分析前列地尔与益气复脉治疗老年心功能不全伴不稳定心绞痛的临床效果。方法:选取2012年2月至2016年2月于我院诊治的心功能不全伴不稳定心绞痛老年患者300例,随机平均分为研究组和对照组各150例。对照组在常规治疗的基础上予以注射用益气复脉(冻干)治疗,研究组则在对照组基础上再予以前列地尔注射液治疗。分析比较两组患者的临床疗效、心电图疗效、心肌缺血发作情况以及心率、血流动力学指标的变化情况和不良反应的发生情况。结果:治疗后,研究组治疗后临床总有效率为96%,显著高于对照组(78%)(P<0.05);研究组治疗后心电图总有效率为88%,显著高于对照组(64%)(P<0.05);研究组心肌缺血的发作次数相比对照组降低程度更大,在各个时段以及总体的心肌缺血的平均发作次数均低于治疗前,且均低于对照组(P<0.05);治疗后,两组患者的LVEF、CO、CI及MPI均明显升高(P<0.05),而心率没有显著变化,研究组的LVEF、CO、CI及MPI显著高于对照组(P<0.05);治疗期间,研究组的血管炎、血管疼痛的发生率显著高于对照组(P<0.05),而其余不良反应发生率比较差异无统计学意义(P>0.05)。结论:前列地尔与益气复脉治疗老年心功能不全伴不稳定心绞痛的疗效明显,可以减少心肌缺血的发作,改善血流动力学,且安全性高。
Objective: To analyze the clinical effects of alprostadil and Yiqi Fumai in treating senile heart dysfunction with unstable angina pectoris. Methods: From February 2012 to February 2016, 300 elderly patients with cardiac dysfunction and unstable angina who were diagnosed and treated in our hospital were randomly divided into study group and control group with 150 cases each. The control group was treated with Yiqi Fumai (lyophilization) on the basis of routine treatment, and the study group was treated with alprostadil injection on the basis of the control group. The clinical curative effect, electrocardiogram curative effect, myocardial ischemic attack, changes of heart rate and hemodynamics index and incidence of adverse reactions in both groups were analyzed and compared. Results: After treatment, the total effective rate of the study group after treatment was 96%, significantly higher than that of the control group (78%) (P <0.05). The total effective rate of the study group after treatment was 88%, significantly higher than that of the control group 64%, respectively) (P <0.05). The number of myocardial ischemia in study group was significantly lower than that in control group. The average number of myocardial ischemia in each time period and the average number of attacks were lower than before treatment, and were lower than the control (P <0.05). After treatment, LVEF, CO, CI and MPI in both groups were significantly increased (P <0.05), while heart rate did not change significantly, the LVEF, CO, CI and MPI in the study group were significantly higher (P <0.05). During the treatment, the incidence of vasculitis and vascular pain was significantly higher in the study group than in the control group (P <0.05), while the incidence of other adverse reactions was not significantly different (P> 0.05) . Conclusion: Alprostadil and Yiqi Fumai treatment of senile cardiac dysfunction with unstable angina obvious effect, can reduce the onset of myocardial ischemia, improve hemodynamics, and high safety.