李娜 王欣鹏 孙成梅

[摘要] 目的 观察阿托伐他汀钙联合尼可地尔治疗不稳定型心绞痛的临床疗效。 方法 将82例不稳定型心绞痛患者随机分为观察组与对照组，每组41例。两组均予常规对症治疗，对照组同时予以阿托伐他汀钙片20 mg/次，每天3次，连用 4 周。观察组在上述治疗的基础上加用尼可地尔5 mg/次，每天3次，连用 4 周。治疗4周后行24 h动态心电图检查，并进行临床疗效评价。 结果 观察组患者治疗后心绞痛症状改善的有效率及心电图改善的总有效率较对照组明显提高，差异有统计学意义（P<0.05）。 结论 阿托伐他汀钙联合尼可地尔治疗不稳定型心绞痛疗效确切，不良心血管事件发生率低，值得临床广泛推广和应用。

[关键词] 不稳定型心绞痛；阿托伐他汀钙；尼可地尔；心电图

[中图分类号] R541.4 [文献标识码] B [文章编号] 1673-9701（2018）02-0089-03

[Abstract] Objective To observe the clinical efficacy of atorvastatin calcium combined with nicorandil in the treatment of unstable angina pectoris. Methods 82 patients with unstable angina pectoris were randomly divided into observation group and control group， with 41 cases in each group. The two groups were given conventional symptomatic treatment， and the control group was given atorvastatin calcium 20 mg/time， 3 times daily for 4 weeks at the same time. The observation group was also treated with nicorandil 5 mg/time， 3 times a day for 4 weeks， based on the above treatment of the control group. After four weeks of treatment， 24-hour ambulatory electrocardiogram examination was performed and the clinical efficacy was evaluated. Results The effective rate of improvement of angina pectoris and the total effective rate of ECG improvement in observation group were significantly higher than those in control group after treatment， with significant difference between the two groups. Conclusion Atorvastatin calcium combined with nicorandil for the treatment of unstable angina pectoris has definite curative effect and low incidence of adverse cardiovascular events， which deserves wide application in clinic.

[Key words] Unstable angina pectoris； Atorvastatin calcium； Nicorandil； Electrocardiogram

不穩定型心绞痛（unstable angina pectoris，UAP）是指介于稳定型心绞痛和急性心肌梗死间的一组急性冠脉综合征，疼痛持续时间长，程度重，有发生急性心肌梗死或猝死的危险[1]。及时有效的治疗可以防止病情发展，改善患者的预后。目前不稳定型心绞痛的治疗主要以药物治疗为主。阿托伐他汀钙作为一种常用他汀类药物，在不稳定型心绞痛治疗中已被证实临床应用效果较好[2-3]。尼可地尔是首个用于临床的ATP敏感钾离子通道开放剂，适用于各种类型的心绞痛[4]。本研究旨在观察阿托伐他汀钙联合尼可地尔治疗不稳定型心绞痛的临床疗效，现报道如下。

1 资料与方法

1.1 临床资料

选择2016年1月～2017年1月期间于我院收治的不稳定型心绞痛患者82例。年龄38～70岁；病程（8.2±1.3）个月。其中吸烟30例，合并高血压39例、糖尿病26例。患者均自愿加入本研究，并签署知情同意书。……