瑞舒伐他汀联合尼可地尔治疗急性冠状动脉综合征临床效果  

Clinical Effect of Rosuvastatin Combined with Nicorandil on Patients with Acute Coronary Syndrome

作　　者：田田 赵殿儒 贾媛媛 马桂英 杨震 罗建平 高丽萍 TIAN Tian;ZHAO Dian-ru;JIA Yuan-yuan;MA Gui-ying;YANG Zhen;LUO Jian-ping;GAO Li-ping(Department of Cardiology,People's Hospital of Cangzhou,Cangzhou,Hebei 061001,China;Department of Clinical Laboratory,People's Hospital of Cangzhou,Cangzhou,Hebei 061001,China;Department of Clinical Laboratory,Beijing Jingmei Group General Hospital,Beijing 102300,China;Department of Paediatrics,Hospital of Yuanshi,Yuanshi,Hebei 051130,China)

机构地区：[1]沧州市人民医院心内科,河北沧州061001 [2]沧州市人民医院检验科,河北沧州061001 [3]北京京煤集团总医院心内科,北京102300 [4]元氏县医院儿科,河北元氏051130

出　　处：《解放军医药杂志》2021年第1期49-53,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省医学科学研究重点课题计划项目(20181135);沧州市重点研发计划指导项目(172302058)。

摘　　要：目的研究瑞舒伐他汀联合尼可地尔治疗急性冠状动脉综合征(ACS)的临床效果及对血管内皮、TLR4/NF-κB信号通路、心功能的影响。方法选择2017年4月—2019年6月收治的128例ACS患者为研究对象,按照治疗方法分为观察组和对照组,每组64例。对照组给予瑞舒伐他汀治疗,观察组在对照组基础上联合尼可地尔口服。2组均治疗6个月。比较2组治疗前后血管内皮指标及血脂水平。观察2组治疗前后TLR4/NF-κB信号通路相关蛋白表达情况,分析治疗前后心功能改善情况。结果 2组治疗后甘油三酯、总胆固醇、内皮素-1、血管性假性血友病因子水平低于治疗前,且观察组低于对照组(P<0.05,P<0.01);2组治疗后一氧化氮水平高于治疗前,且观察组高于对照组(P<0.05)。2组治疗后白介素-6、肿瘤坏死因子-α水平、Toll样受体蛋白、NF-κB蛋白水平低于治疗前,且观察组低于对照组(P<0.05,P<0.01)。治疗后2组左心室舒张末期内径、左心室收缩末期内径、左心室舒张末期容积及左心室收缩末期容积水平低于治疗前,且观察组低于对照组(P<0.05,P<0.01);治疗后2组左心室射血分数高于治疗前,且观察组高于对照组(P<0.05,P<0.01)。治疗期间2组不良发应发生率比较差异无统计学意义(P>0.05)。结论瑞舒伐他汀联合尼可地尔可改善ACS患者血管内皮功能,降低血脂水平,下调TLR4/NF-κB信号通路,促进心功能恢复。Objective To study the clinical effect of Rosuvastatin combined with Nicorandil in the treatment of patients with acute coronary syndrome(ACS)and its effect on vascular endothelium,TLR4/NF-κB signaling pathway and cardiac function.Methods A total of 128 patients with ACS who were admitted to our hospital from April 2017 to June 2019 were included in the study.They were divided into observation group and control group,with 64 cases in each group.The control group was given Rosuvastatin,and the observation group was supplemented with Nicorandil on the basis of observation group.Both groups were treated for 6 months.The vascular endothelial indexes and blood lipid levels of the two groups were compared before and after treatment.The expression of TLR4/NF-κB signaling pathway related proteins before and after treatment in both groups were observed,and the improvement of cardiac function before and after treatment were compared in the two groups.Results After treatment,the levels of triglyceride(TC),total cholesterol(TG),endothelin-1(ET-1),and von Willebrand factor(vWF)were lower than those before treatment in the two groups,and the above indicators in the observation group was significantly lower than those in the control group(P<0.05,P<0.01).The level of NO was higher after treatment than that before treatment in both groups,and the level in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),Toll-like receptor(TLR)protein and NF-κB protein were lower in the two groups,as compared with those before treatment,and the levels in the observation group were significantly lower than those in the control group(P<0.05,P<0.01).After treatment,the levels of left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular end diastolic volume(LVEDV),and left ventricular end systolic volume(LVESV)were lower in both groups,and the degree of decrease in LVEDD,LVESD,LV

关 键 词：急性冠状动脉综合征 瑞舒伐他汀 尼可地尔 总胆固醇 内皮素-1 血管性假性血友病因子 核因子ΚB 左心室射血分数 

分 类 号：R543.3[医药卫生—心血管疾病]