目的 探讨单硝酸异山梨酯片联合尼可地尔片治疗2型糖尿病合并稳定型心绞痛的临床疗效。方法 选取海南省第二人民医院2014年2月—2015年3月收治的2型糖尿病合并稳定型心绞痛患者90例,随机分为对照组和治疗组,每组各45例。两组患者均给予常规降血脂、降血糖等基础治疗。对照组口服尼可地尔片,5 mg/次,3次/d;治疗组在此基础上加服单硝酸异山梨酯片,20 mg/次,2次/d。两组患者均持续治疗4周。比较两组患者治疗前后心绞痛疗效和心电图疗效。记录两组患者治疗前后的心绞痛发作次数、持续时间。同时比较两组患者治疗前后血脂、空腹血糖(FBG)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平情况。结果 治疗后治疗组的心绞痛治疗有效率为91.11%,显著高于对照组的75.56%,两组心绞痛有效率比较差异具有统计学意义(P<0.05)。治疗后治疗组的心电图治疗有效率为91.11%,显著高于对照组的73.33%,两组心电图治疗有效率比较差异具有统计学意义(P<0.05)。治疗后两组患者的心绞痛发作频率、发作时间较治疗前均显著降低(P<0.05),且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后两组患者的三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)较治疗前均显著降低,高密度脂蛋白(HDL-C)显著升高(P<0.05)。治疗后两组患者的SOD、MDA水平较治疗前均显著改善(P<0.05),且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 单硝酸异山梨酯片联合尼可地尔片治疗2型糖尿病合并稳定型心绞痛疗效较好,可显著降低患者心绞痛发作频率、发作时间,改善患者预后,具有一定的临床推广应用价值。

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.