李东江 杨乔乔

【摘要】 目的：探討阿司匹林与比索洛尔联合用药对冠心病经皮冠状动脉介入术后患者心脏康复的影响。方法：选择笔者所在医院2015年1月-2018年12月收治的冠心病经皮冠状动脉介入术后患者100例作为研究对象，全部入组患者均按照随机数字法进行分组，对照组50例单独使用阿司匹林100 mg/d治疗，观察组50例在阿司匹林的前提下，联合比索洛尔2.5 mg/次，比较两组患者治疗前后心排出量、心脏指数、射血分数、生活质量（SF-36评量表）、治疗总有效率、不良反应发生率。结果：观察组治疗总有效率高于对照组，差异有统计学意义（P<0.05）。治疗前两组CO、CI、LVEF比较差异无统计学意义（P>0.05）;治疗后两组各指标均高于治疗前，且观察组高于对照组，差异均有统计学意义（P<0.05）。治疗前两组生活质量比较差异无统计学意义（P>0.05）;治疗后两组各评分均高于治疗前，且观察组高于对照组，差异均有统计学意义（P<0.05）。观察组不良反应发生率低于对照组，差异有统计学意义（P<0.05）。结论：采用阿司匹林联合比索洛尔治疗冠心病经皮冠状动脉介入术后患者，可以有效改善患者心肌缺血缺氧，有利于缓解患者的心绞痛，从而有效地改善心功能。

【关键词】 阿司匹林 比索洛尔 联合用药 冠心病 经皮冠状动脉介入术 心脏康复

doi：10.14033/j.cnki.cfmr.2019.29.017 文献标识码 B 文章编号 1674-6805（2019）29-00-03

[Abstract] Objective： To investigate the effect of Aspirin combined with Bisoprolol on cardiac rehabilitation in patients with coronary heart disease after percutaneous coronary intervention. Method： A total of 100 patients with coronary heart disease after percutaneous coronary intervention were selected as the study subjects from January 2015 to December 2018. All patients were divided into two groups according to random number method. A total of 50 patients in the control group were treated with Aspirin 100 mg/d alone. While 50 patients in the observation group were treated with Bisoprolol 2.5 mg/time on the premise of Aspirin. After treatment， cardiac output， cardiac index， ejection fraction， quality of life （SF-36 scale）， treatment efficiency and adverse reaction rate were measured. Result： The total effective rate of the observation group was higher than that of the control group， the difference was statistically significant （P<0.05）. There was no significant difference in CO， CI， LVEF between the two groups before treatment （P>0.05）， but the indexes in the two groups after treatment were higher than those before treatment， and the observation group was higher than the control group， the differences were statistically significant （P<0.05）. There was no significant difference in quality of life between the two groups before treatment （P>0.05）， after treatment， the scores of each group were higher than before treatment， and the observation group was higher than the control group， the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the observation group was lower than that in the control group， and the difference was statistically significant （P<0.05）. Conclusion： Aspirin combined with Bisoprolol in the treatment of patients with coronary heart disease after percutaneous coronary intervention can effectively improve myocardial ischemia and hypoxia， alleviate angina pectoris， and thus effectively improve cardiac function.

[Key words] Aspirin Bisoprolol Combination therapy Coronary heart disease Percutaneous coronary intervention Cardiac rehabilitation

First-authors address： Zigui County Peoples Hospital， Zigui 443600， China

冠心病由冠状动脉粥样硬化所致，引起心肌供血不足，致使心肌细胞变性坏死，从而引发心力衰竭[1]。近年来我国冠心病的发病率明显升高，发病患者逐渐趋于年轻化，严重威胁到中老年人群的健康和生命。现阶段冠心病的主要疗法为药物疗法、手术疗法，其中手术疗法主要包括经皮冠状动脉介入术（PCI），可以帮助患者重建心肌血运通路，改善心功能[2]。但是术后容易引起一定的并发症，需要给予抗血小板治疗。阿司匹林是常用的抗血小板治疗的药物，但是单独使用阿司匹林难以有效地改善患者的冠状动脉血流，因此需要结合其他药物提高疗效[3]。……