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作 者:孙琪[1] 张健[1] 吕晓燕 石宇杰[1] 李俊峡[1]
机构地区:[1]北京军区总医院心血管疾病研究所二区,北京100700 [2]八一电影制片厂门诊部
出 处:《中国循证心血管医学杂志》2015年第6期748-750,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine
基 金:吴阶平医学基金会临床科研专项资助(32067001173)
摘 要:目的 分析瑞舒伐他汀联合尼可地尔治疗冠状动脉慢血流现象的临床疗效。方法 入选2010年1月-2014年1月在北京军区总医院经冠状动脉造影发现冠状动脉慢血流现象的患者50例,随机分为他汀组(n=24)和联合用药组(n=26),他汀组口服瑞舒伐他汀10 mg,1次/d,联合用药组口服瑞舒伐他汀10 mg,1次/d,及尼可地尔5 mg,3次/d;疗程为6个月。6个月后行冠状动脉造影观察各支冠状动脉血流速度。检测及比较治疗前、后血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及高敏C反应蛋白(hs-CRP)、内皮素-1(ET-1)、一氧化氮(NO)浓度水平。结果 治疗6个月后他汀组及联合用药组各支冠状动脉血流速度均优于治疗前(P〈0.05),联合用药组各支冠状动脉血流速度改善优于他汀组(P〈0.05);与本组治疗前相比,TC、TG、LDL、hs-CRP及ET-1水平均明显降低(P〈0.05),而NO水平明显升高(P〈0.05);联合用药组治疗后与他汀组治疗后相比,TC、TG、LDL-C差别无显著性,而hs-CRP及ET-1水平明显降低(P〈0.05),NO水平明显升高(P〈0.05)。结论 瑞舒伐他汀及尼可地尔合应用可抑制炎症反应、改善内皮功能进而改善冠状动脉慢血流现象,效果优于单用瑞舒伐他汀。Objective To study the therapeutic effect of rosuvastatin and nicorandil in patients with coronary slow flow. Methods A total of 50 patients with coronary slow flow and chest pain were randomly divided into 2 groups. The statin group(n=24) were treated with rosuvastatin 10 mg Qn. The combined therapy group(n=26) were treated with rosuvastatin 10 mg Qn and nicorandil 5mg tid. All patients were treated for 6 months. After 6 months, the coronary flow velocity in all three coronaries were measured by angiograph. TC, TG, LDL, HDL, hsCRP, ET-1, NO were detected before and after treatment. Results: 6 months later, the coronary flow velocity in all three coronaries of both statin group and combined therapy group was significantly improved(P〈0.05). The combined therapy group improved more significantly than the statin group(P〈0.05). Compared with 6 months before in the same group, the level of TC, TG, LDL, hs-CRP and ET-1(P〈0.05).But the level of NO(P〈0.05);Compared with statin group 6 months later, there were no significant difference among TC, TG and LDL. While the level of hs-CRP and ET-1 were decreased significantly(P〈0.05),and the level of NO was elevated significantly(P〈0.05). Conclusions: Combination of rosuvastatin and nicorandil can both inhibit the inflammatory response and improve the endothelial function. Then it was effective to the patients with coronary slow flow. The efficacy of combined therapy was superior to the statin alone.
分 类 号:R543.3[医药卫生—心血管疾病]
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