Point Of The Original Pump Lsoket Treating Coronary Heat Disease With Heart Failure Observation Of Efficacy And Clinical Safety

With the continuous improvement of living standards, longer life expectancy, high blood pressure, coronary heart disease and other cardiovascular disease incidence in the population year by year, so all the final stage of the development of cardiovascular disease-heart failure, has become the world within the major public health problem. According to ESC statistics,47 countries in Europe nearly 10 million people, about 5% of patients with heart failure, the United States suffer from heart failure by 500 million, an annual increase of 50 million patients. According to our survey of 50 hospital patients, heart failure hospitalizations, cardiovascular disease accounted for 20% over the same period. Its high incidence and high mortality to bring a great energy and financial burden, has attracted wide attention from scholars. Reduce the cardiac stress in heart failure treatment:In addition to proper control of the amount of exercise, limiting sodium intake, diuretics, the main application of vasodilators:for left ventricular failure by expanding the small arteries and veins, reducing the heart before and after the load and improve efforts failure, hemodynamics, thereby relieving the symptoms, the clinical application of nitrates in the main. In recent years, Isoket as a vasodilator drug, widely used in coronary heart disease, pulmonary hypertension, acute severe hypertension, heart failure and other therapeutic areas, but the liquid through the micro direct intravenous infusion pump treatment of coronary heart disease and heart failure few reports on clinical safety. Based on the Department of Cardiology, PLA 208 Hospital, from January 2008 to December 2010157 cases of complete clinical information (other than 15 cases have been treated can not tolerate the side effects to stop treatment in patients with no mark below) coronary heart disease patients with heart failure to take a different concentration of intravenous administration of intravenous single Isoket and the concentration of nitroglycerin were studied retrospectively. Comprehensive analysis of the original pump Isoket point dilution of intravenous treatment of coronary heart failure clinical efficacy and safety of clinical application of how scientific treatment of coronary heart Isoket provide an objective scientific basis.Objective:This paper examines Isoket (Isoket) administration of different concentrations of the clinical efficacy of treatment of coronary heart failure, and compared Isoket (Isoket) stock solution and diluted with the intravenous administration of nitroglycerin (NTG) of the clinical efficacy and clinical safety situation.Methods:A retrospective analysis from January 2008 to December 2010 in our hospital 157 cases of Cardiology, Hospital Grade III or IV cardiac functional class in heart failure patients with coronary heart disease in the application of ACEI, diuretics and other conventional treatment based on were randomly divided into three groups:group Isoket liquid (N=52), female 24 cases,28 males, aged 60-84 years, mean (76.4±4.9) years; Isoket dilute solution (N=53),26 females,27 males, aged 59-86 years, mean (75.8±4.5) years; intravenous nitroglycerin group that the control group (N= 52), female 27 cases,25 males, age 57-86 years, mean (72.4±4.1) years. Between different groups were compared from the following aspects:age, before treatment Braunwald classification, cardiac function before treatment, angina pectoris, ECG improvement rate, cardiac function was improved and the incidence of adverse drug The incidence of reactions.Results:Isoket dilution, stock solution group and the control group three cases of age, before treatment Braunwald classification of cardiac function before treatment in each group showed no significant differences between ethnic groups have comparable data. Isoket liquid group, dilution and control groups improved after treatment the incidence of angina pectoris:Isoket liquid group (33/52) 63.46%; Isoket dilution group (32/53) 60.38%; nitroglycerin group (23/52) 44.23%. Isoket liquid group and dilute solution to improve the incidence of angina pectoris compared (P> 0.05), group Isoket liquid nitroglycerin group compared the incidence of angina pectoris improved (P<0.05), diluted Isoket liquid group and nitroglycerin group compared the incidence of angina pectoris improved (P <0.05), Isoket was no significant difference between the two groups, respectively, compared with nitroglycerin among the groups were statistically significant differences. Isoket liquid group, dilution 1 treatment group and control group on Wednesday, resting ECG group of patients the incidence of:Isoket liquid group (41/52) 78.85%; Isoket dilution group (41/53) 77.36%; nitroglycerin group (30/52) 57.69%. Isoket dilution liquid group and no significant difference between groups. Isoket liquid group, dilute solution and nitroglycerin group differences were statistically significant. Isoket liquid group, dilution and control groups improved after treatment the incidence of cardiac function:Isoket liquid group (49/52) 94.23%; Isoket dilution group (42/53) 79.25%; nitrate glycerol group (33/52) 63.46%. Isoket liquid group, dilution group and control group after treatment LVEF and E/A to improve the situation:Isoket dilution liquid group and treatment group Isoket better than the nitroglycerin group (P<0.05) was statistically significant; Isoket dilution liquid group and treatment group comparison between the two groups (P> 0.05), not statistically significant. Three groups the incidence of adverse reactions:headache:Isoket liquid group (10/54) 18.52%; Isoket dilution group (11/56) 19.64%; nitroglycerin group (30/62) 48.39 %. Isoket dilution liquid group and no significant difference between groups (P> 0.05). Isoket liquid group, dilute solution and nitroglycerin group differences were statistically significant (P<0.05). Dizziness, nausea, vomiting:Isoket liquid group (11/54) 20.37%; Isoket dilution group (12/56) 21.43; nitroglycerin group (31/62) 50.00%. Isoket dilution liquid group and no significant difference between groups (P> 0.05). Isoket liquid group, dilute solution and nitroglycerin group differences were statistically significant (P<0.05). Due to a strong headache, severe dizziness, nausea, vomiting, leaving the patient can not tolerate, nitroglycerin group (10/62) 16.13% higher than Isoket liquid group (2/54) 3.70% and dilute solution (3/56) 5.36%, the difference was statistically significant (P<0.05). Heart rate, SBP↓, DBP↓side effect:Although nitroglycerin group than Isoket dilution liquid group and the group, but the difference was not statistically significant (P> 0.05). The overall incidence of side effects:Nitroglycerin group proportions (155/ 310) than in group form Isoket liquid ratio (84/270) and group composition Isoket dilution ratio (96/280), the difference was statistically significant (P<0.05).Conclusion:1, different drug concentrations (stock solution, diluted liquid) application Isoket improvement in the control of angina symptoms and ECG aspects of heart failure symptoms and improve the clinical efficacy could be good, and better than nitroglycerin. Improve heart failure symptoms, Isoket dilution liquid treatment group than in groups.2., Isoket has a good safety, adverse reactions, especially hypotension was significantly lower than in the nitroglycerin.