尼可地尔对高龄老年冠心病合并2型糖尿病患者血运重建后心绞痛及血管内皮功能的影响  

Influence of nicorandil on angina pectoris and vascular endothelial function after revascularization in elderly patients with coronary heart disease and type 2 diabetes mellitus

作　　者：毕磊 田国祥[1] 樊茹[2] 张峰[1] 李响 武云涛 Bi Lei;Tian Guoxiang;Fan Ru;Zhang Feng;Li Xiang;Wu Yuntao(Department of Geriatric Medicine,Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700,China;不详)

机构地区：[1]解放军总医院第七医学中心老年医学科,北京100700 [2]解放军总医院第一医学中心,北京100005

出　　处：《中国循证心血管医学杂志》2021年第10期1179-1181,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：军队保健专项课题(15BJZ03);全军十二五面上课题(CWS11J216)。

摘　　要：目的观察尼可地尔对高龄老年冠心病(CHD)合并2型糖尿病(T2DM)患者冠状动脉(冠脉)血运重建后心绞痛的疗效及血管内皮细胞功能的影响。方法选择2016年1月至2019年1月于解放军总医院第七医学中心老年医学科心血管病区住院的高龄CHD合并T2DM患者心绞痛发作的患者116例,所有患者均行经皮冠脉介入治疗(PCI)或冠脉旁路移植术(CABG)治疗。随机分为试验组和对照组,每组各58例。试验组在冠心病二级预防药物治疗基础上,口服尼可地尔5 mg Tid,观察治疗4周。采用血管内皮功能监测仪Endo PAT2000测定血管内皮功能指数(RHI),评估血管内皮功能。观察两组患者治疗后RHI及心绞痛发作频率和持续时间,评价两组心绞痛疗效并记录不良反应。结果治疗前后两组患者肝肾功能无明显变化,治疗后两组心绞痛发作次数和持续时间均有所减少(P<0.05),试验组治疗4周后心绞痛发生次数与持续时间小于对照组(P<0.05)。试验组治疗4周后血管内皮功能明显改善,RHI较治疗前和对照组治疗后明显升高,差异有统计学意义(P<0.05)。结论尼可地尔能够降低高龄老年CHD合并T2DM患者血运重建后心绞痛发作次数及持续时间,进一步改善血管内皮细胞功能,安全性好。Objective To observe the curative effect of nicorandil on angina pectoris(AP)and its influence on vascular endothelial function after revascularization in elderly patients with coronary heart disease(CHD)and type 2 diabetes mellitus(T2DM).Methods The elderly patients with CHD and T2DM(n=116)were chosen from District of Cardiovascular Medicine of Department of Geriatric Medicine in the Seventh Medical Center of Chinese PLA General Hospital from Jan.2016 to Jan.2019,and all patients received PCI or CABG treatment.All patients were divided randomly into test group and control group(each n=58).The test group was treated with nicorandil(5 mg,tid)on the basis of secondary preventive medication for CHD for 4 weeks.Endo PAT2000(a monitor for vascular endothelial function)was used to detect reactive hyperemia index(RHI)for reviewing vascular endothelial function.RHI and frequency and duration of AP attack were observed,therapeutic effect on AP was reviewed,and adverse reactions were recorded in 2 groups after treatment.Results The liver and kidney functions had no significant changes before and after treatment,and frequency and duration of AP attack decreased in 2 groups after treatment(P<0.05).The frequency and duration of AP attack were less in test group than those in control group after treatment for 4 weeks(P<0.05).The was significantly improved,RHI increases significantly in test group after treatment for 4 weeks compared with control group and before treatment(P<0.05).Conclusion Nicorandil can reduce frequency and duration of AP attack in elderly patients with CHD and T2DM after revascularization,and further improve vascular endothelial function with higher safety.

关 键 词：尼可地尔 冠心病 2型糖尿病 心绞痛 血管内皮功能 老年 

分 类 号：R541.4[医药卫生—心血管疾病]