尼可地尔联合阿托伐他汀治疗合并心脏损害的系统性红斑狼疮患者的疗效  

Effects of nicorandil combined with atorvastatin in treatment of systemic lupus erythematosus patients with cardiac damage

作　　者：张帆[1] 马丽[2] 贺立群[1] 方勇[1] 冷沁[1] 祝炜[1] 王超[1] 

机构地区：[1]武汉市第一医院心内科,湖北武汉430022 [2]武汉科技大学附属天佑医院心内科,湖北武汉430064

出　　处：《临床和实验医学杂志》2017年第3期260-263,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的观察尼可地尔联合阿托伐他汀治疗合并心脏损害的系统性红斑狼疮患者的疗效。方法选取110例合并心脏损害的系统性红斑狼疮患者,按随机、对照、单盲的方法分为两组。对照组55例给予常规药物治疗;治疗组55例在常规药物治疗基础上加用尼可地尔联合阿托伐他汀治疗,疗程均为半年。两组患者治疗前、后均分别检测动态心电图,心脏彩超测左心室射血分数(LVEF%)以及血中氨基末端脑钠肽前体(NT-pro BNP)、一氧化氮(NO)、超敏C反应蛋白(hs-CRP)、内皮素-1(ET-1)水平。结果与治疗前比较,两组患者治疗后ST段压低的次数、持续的时间及心肌缺血总负荷均明显减少,差异有统计学意义(P<0.01);且治疗组治疗后上述指标改善优于对照组,差异有统计学意义(P<0.01)。与治疗前比较,对照组治疗后LVEF%、NT-pro BNP、NO、hs-CRP、ET-1改善均不明显,差异无统计学意义(P>0.05);而治疗组治疗后上述指标改善显著,差异有统计学意义(P<0.05);且治疗组与对照组治疗后比较,上述指标改善亦显著,差异有统计学意义(P<0.05)。结论尼可地尔联合阿托伐他汀治疗,对改善合并心脏损害的系统性红斑狼疮患者的心肌缺血、左心室射血分数以及血管内皮功能有一定疗效。Objective To observe the effects of nicorandil combined with atorvastatin in treatment of systemic lupus erythematosus（ SLE）patients with cardiac damage.Methods SLE patients with cardiac damage were divided into two groups according to the single blind,randomized,controlled method：control group（ n = 55）,received routine treatment only.The treatment group（ n = 55）,received nicorandil combined with atorvastatin on the basis of routine treatment.Before and 6 months after treatment,dynamic electrocardiogram,left ventricular ejection fraction（ LVEF） % were recorded in both groups,the plasma level of amino terminal brain natriuretic peptide precursor（ NT-pro BNP）,nitricoxide（ NO）,hypersensitive c-reactive protein（ hs CRP） and endothelin-1（ ET-1） were also recorded to evaluate the effect of the treatment.Results The falling of ST segment,duration time,and the total load of myocardial ischemia were significantly reduced in both groups after treatment compared with the original,the comparative difference was statistically significant（ P〈0.01）.There were no statistical difference of LVEF%,NT-pro BNP,NO,hs-CRP,ET-1 in control group after treatment compared with the original（ P〉0.05）.After treatment,the above indicators in the treatment group were improved significantly compared with the original and controls（ P〈0.05）.Conclusion The treatment of nicorandil combined with atorvastatin can improve myocardial ischemia,left ventricular function and endothelial function in SLE patients with cardiac damage.

关 键 词：系统性红斑狼疮 心脏损害 尼可地尔 阿托伐他汀 疗效 

分 类 号：R593.241[医药卫生—内科学] R541[医药卫生—临床医学]