Objective To study the curative effect of nicorandil in very old patients with multiple coronary branch lesions and chronic heart failure (CHF).Methods Ninety-six very old patients with multiple coronary branch lesions and CHF admitted to our hospital from January 2012 to July 2016 were randomly divided into experimental group (n=48) and control group (n=48).Patients in experimental group were treated with oral nicorandil (5 mg,3 times a day) while those in control group were treated with isosorbide mononitrate (20 mg,twice a day) in addition to conventional treatment.Their serum B-type natriuretic (BNP) level,LVEF,left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were measured before and after treatment.The curative effect and adverse reaction were compared between the 2 groups after 6 months of treatment.Results The significant efficacy and total effective rate of nicorandil for angina pectoris and cardiac function were significantly higher in experimental group than in control group after 6 months of treatment (31.3 ％ vs 10.4 ％,83.3 ％ vs 60.4 ％,P＜0.05;31.3％ vs 14.6％,75.0％ vs 54.2％,P＜0.05).The LVEF was significantly higher while the serum BNP level was significantly lower,the LVESD and LVEDD were significantly shorter in experimental group than in control group after 6 months of treatment (P＜0.05).Conclution Nicorandil can effectively reduce the risk of angina pectoris and improve the cardiac function in very old patients with multiple coronary branch lesions and CHF.%目的 研究尼可地尔对高龄冠状动脉多支病变合并慢性心力衰竭患者的治疗效果.方法 选择2012年1月～2016年7月在解放军153中心医院住院的高龄冠状动脉多支病变合并慢性心力衰竭患者96例,随机分为实验组48例和对照组48例.2组在常规治疗基础上,实验组口服尼可地尔5 mg,3次/d,对照组口服单硝酸异山梨酯缓释片20 mg,2次/d,治疗前后均测定B型钠尿肽和超声心动图测定左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)、LVEF.观察2组治疗后6个月疗效及不良反应.结果 实验组治疗6个月心绞痛显效和总有效率明显高于对照组(31.3％ vs 10.4％,83.3％ vs 60.4％,P＜0.05).实验组治疗6个月心功能显效和总有效率明显高于对照组(31.3％ vs 14.6％,75.0％ vs 54.2％,P＜0.05).实验组治疗6个月LVEF较治疗前和对照组治疗后明显升高,B型钠尿肽、LVEDD和LVESD较治疗前和对照组治疗后明显减小,差异有统计学意义(P＜0.05).结论 尼可地尔能够明显降低高龄冠状动脉多支病变合并慢性心力衰竭患者的心绞痛发生风险,进一步改善心功能.
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