目的 观察尼可地尔对慢性充血性心力衰竭患者心脏功能及血糖的影响.方法 64例慢性心衰患者随机分为对照组(n=32)和治疗组(n=32),对照组使用常规抗心衰及基础疾病治疗药物,治疗组在使用上述药物的基础上口服ATP敏感钾离子(KATP)通道开放剂尼可地尔(nicorandil,NCR),5mg/次,每日3次,疗程12周.观察治疗前后6分钟步行距离实验(6MWT)、血浆氨基末端脑钠肽前体(NT-proBNP)、空腹血浆血糖(FPG)、餐后2小时血糖(P2hPG)、糖化血红蛋白Alc (GHbAIc)的变化.结果 治疗后,两组患者6分钟步行距离及血浆NT-proBNP水平均改善(P＜0.01),治疗组优于对照组(P＜0.05)；FPG、P2hPG、GHbAlc在组间比较均无显著性差异(P＞0.05).结论 尼可地尔能提高慢性充血性心力衰竭患者运动耐量,降低血浆NT-proBNP水平,且对血糖水平无明显影响.%Objective To explore the effects of nicorandil on cardiac function and blood glucose in patients with chronic heart failure (CHF). Methods 64 patients with CHF were randomly divided into control group and treatment group. Both 2 groups received conventional therapy for heart failure. And the treatment group was treated with nicorandil additionally (5 mg once, 3 times a day for 12 weeks). 6-minute walk text (6MWT), plasma N-terminal-pro brain natriuretic peptide (NT-proBNP), fasting plasma glucose (FPG), postprandial 2 hours plasma glucose (P2hPG) and glycated hemoglobin Ale (GHbAlc) were measured before and after treatment. Results After the treatment, the 6-minute walking distance and the plasma NT-proBNP levels of both groups were improved significantly (P<0.01), especially in treatment group (P<0.05); the level of FPG, P2hPG and GHbAlc were not significantly different between 2 groups. Conclusion Nicorandil can effectively improve the exercise tolerance of the patients with CHF, reduce the Plasma NT-proBNP level, but it has no effect on the level of blood glucose.
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