强化他汀联合增强型体外反搏治疗不稳定型心绞痛对复发率及Endocan-1、Vaspin水平的影响  

Effect of Intensive Statin Combined with Enhanced External Counterpulsation on the Angina Recurrence Rate and Endocan-1,Vaspin Levels of Unstable Angina Patients

作　　者：王计亮 李贵龙 赵鹏 汪凤勃 Wang Jiliang;Li Guilong;Zhao Peng;Wang Fengbo(Department of Cardiology,Xingtai Third Hospital,Xingtai 054000,Hebei,China)

机构地区：[1]邢台市第三医院心血管内科,河北邢台054000

出　　处：《药物流行病学杂志》2022年第5期291-295,共5页Chinese Journal of Pharmacoepidemiology

基　　金：河北省卫健委2019年度医学科学研究项目(编号:20191679)。

摘　　要：目的:观察强化他汀联合增强型体外反搏(EECP)治疗不稳定型心绞痛对复发率及内皮细胞特异分子-1(Endocan-1)、脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)水平的影响。方法:132例不稳定型心绞痛(UAP)患者随机分为观察组和对照组各66例。对照组给予单纯阿托伐他汀强化治疗,观察组在对照组基础上联用EECP治疗。观察两组临床疗效,比较两组患者治疗前后血压、心率、临床症状,以及炎症因子[白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)]、Endocan-1、Vaspin水平和血流介导舒张功能(FMD)等指标变化;随访1年,比较两组心绞痛复发率。结果:观察组临床总有效率为84.85%,显著高于对照组的68.18%(P<0.05)。治疗后,两组患者的心率、收缩压、ST段压低等指标较前明显改善,心绞痛发作次数、持续时长较前明显下降,且观察组各项指标均优于对照组(P<0.05)。治疗后,两组血清hs-CRP、TNF-α、IL-6、Endocan-1水平较前明显下降,血清Vaspin水平及FDM较前明显升高(P<0.05);且观察组各项指标均优于对照组(P<0.05)。随访1年,观察组UAP复发率明显低于对照组(P<0.05)。结论:强化他汀治疗联合EECP治疗UAP复发疗效显著,可明显改善患者临床指标和症状,降低血清炎症因子水平,调节血清Endocan-1以及Vaspin水平以改善血管内皮功能,且在一年随访期内可有效降低UAP复发率。Objective:To observe the effects of intensive statin combined with enhanced external counterpulsation(EECP)on the angina recurrence and endothelial cell specific molecule-1(Endocan-1),visceral adipose tissue-derived serine protease inhibitor(Vaspin)of unstable angina patients.Methods:132 patients with unstable angina pectoris(UAP)were divided randomly into observation group and control group with 66 cases in each group.The patients in the control group were given atorvastatin alone,and the patients in the observation group was treated with EECP on the basis of the control group.The clinical efficacy of the two groups of patients,the clinical indicators such as blood pressure,heart rate and clinical symptoms,inflammatory factor levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP)],Endocan-1,Vaspin,and flow-mediated dilation(FDM)of each group before and after treatment were compared.The recurrence rate of angina pectoris within one year of follow-up between the two groups was compared.Results:The total effective rate of the observation group was 84.85%,which was significantly higher than 68.18%of the control group(P<0.05).After treatment,the indexes of heart rate,systolic blood pressure and ST-segment depression in the two groups were significantly improved,and the frequency and duration of angina pectoris in the two groups were significantly lower than those before.Above indexes of the observation group were significantly better than those of the control group(P<0.05);After treatment,hs-CRP,TNF-α,IL-6 and Endocan-1 in both groups were decreased significantly than before,and Vaspin levels and FDM in both groups were increased significantly than before(P<0.05).The indexes of the observation group were significantly better than those of the control group(P<0.05).After a one-year follow-up,the incidence of UAP recurrence in the observation group was lower than that in the control group(P<0.05).Conclusion:Intensive statin combined with EECP has a significant clinical

关 键 词：强化他汀治疗 增强型体外反搏 不稳定型心绞痛 疗效 内皮细胞特异分子-1 脂肪特异性丝氨酸蛋白酶抑制剂 

分 类 号：R541.1[医药卫生—心血管疾病]