目的 探討單硝酸異山梨酯片聯(lián)合尼可地爾片治療2型糖尿病合并穩(wěn)定型心絞痛的臨床療效。方法 選取海南省第二人民醫(yī)院2014年2月—2015年3月收治的2型糖尿病合并穩(wěn)定型心絞痛患者90例,隨機(jī)分為對(duì)照組和治療組,每組各45例。兩組患者均給予常規(guī)降血脂、降血糖等基礎(chǔ)治療。對(duì)照組口服尼可地爾片,5 mg/次,3次/d;治療組在此基礎(chǔ)上加服單硝酸異山梨酯片,20 mg/次,2次/d。兩組患者均持續(xù)治療4周。比較兩組患者治療前后心絞痛療效和心電圖療效。記錄兩組患者治療前后的心絞痛發(fā)作次數(shù)、持續(xù)時(shí)間。同時(shí)比較兩組患者治療前后血脂、空腹血糖(FBG)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平情況。結(jié)果 治療后治療組的心絞痛治療有效率為91.11%,顯著高于對(duì)照組的75.56%,兩組心絞痛有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后治療組的心電圖治療有效率為91.11%,顯著高于對(duì)照組的73.33%,兩組心電圖治療有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后兩組患者的心絞痛發(fā)作頻率、發(fā)作時(shí)間較治療前均顯著降低(P<0.05),且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后兩組患者的三酰甘油(TG)、總膽固醇(TC)、低密度脂蛋白(LDL-C)較治療前均顯著降低,高密度脂蛋白(HDL-C)顯著升高(P<0.05)。治療后兩組患者的SOD、MDA水平較治療前均顯著改善(P<0.05),且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 單硝酸異山梨酯片聯(lián)合尼可地爾片治療2型糖尿病合并穩(wěn)定型心絞痛療效較好,可顯著降低患者心絞痛發(fā)作頻率、發(fā)作時(shí)間,改善患者預(yù)后,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical effect of Isosorbide Mononitrate Tablets combined with Nicorandil Tablets in treatment of type 2 diabetic patients with stable angina pectoris. Methods Patients (90 cases) with stable angina pectoris in the Second People's Hospital of Hainan Province from February 2014 to March 2015 were randomly divided into control group and treatment group, and each group had 45 cases. All patients were given conventional basic treatment with lipid lowering, hypoglycemic, etc. The patients in the control group were po administered with Nicorandil Tablets, 5 mg/time, three times daily. The patients in the treatment group were po administered with Isosorbide Mononitrate Tablets on the basis of the control group, 20 mg/d, twice daily. The patients in two groups were treated for 4 weeks. After treatment, angina pectoris efficacies and electrocardiogram efficacies were evaluated. And angina pectoris frequency and duration in two groups were recorded. In the same time, the levels of blood lipid, FBG, SOD, and MDA in two groups before and after treatment were compared. Results After treatment, angina pectoris efficacy in the treatment groups was 91.11% which was significantly higher than that (75.56%) of the control group, and electrocardiogram efficacy in the treatment groups was 91.11% which was obviously higher than that (73.33%) of the control group, and there were significant differences between two groups (P < 0.05). After treatment, angina pectoris frequency and duration in two groups were obviously decreased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, levels of TG, TC, and LDL-C in two groups were significantly decreased (P < 0.05), but levels of HDL-C were obviously increased (P < 0.05). After treatment, the levels of SOD and MDA in the two groups were significantly improved (P < 0.05), and these observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Isosorbide Mononitrate Tablets combined with Nicorandil Tablets has the good clinical effect in treatment of type 2 diabetic patients with stable angina pectoris, and can significantly decrease angina pectoris frequency and duration and improve patient outcomes which has a certain clinical application value.