尼可地尔对老年2型糖尿病合并冠状动脉多支病变患者心绞痛的治疗效果和炎症因子的影响  

Effect of Nicorandil on the Efficacy of Angina Pectoris and Inflammatory Factors in Elderly Patients with Type 2 Diabetes Mellitus Combined with Multiple Coronary Artery Lesions

作　　者：边亚 刘广阔 郭洁[1] 陈晋波[1] 吕小棉 BIAN Ya;LIU Guangkuo;GUO Jie;CHEN Jinbo;LYU Xiaomian(Department of Cardiology,Shijiazhuang Second Hospital,Shijiazhuang 050051,China;Department of Gastroenterology,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省石家庄市第二医院心血管内科,050051 [2]河北省人民医院消化内科,河北省石家庄市050051

出　　处：《实用心脑肺血管病杂志》2022年第9期94-99,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河北省卫生和计划生育委员会科研基金(20201345)。

摘　　要：日的 探究尼可地尔对老年2型糖尿病(T2DM)合并冠状动脉多支病变患者心绞痛的治疗效果和炎症因子的影响。方法 选取2017年6月至2020年9月石家庄市第二医院收治的老年T2DM合并冠状动脉多支病变患者84例,采用简单随机方法分为对照组和试验组,每组42例。两组入院后均接受糖尿病健康教育,采用统一降糖方案,在上述治疗方案基础上对照组采取常规治疗,试验组在对照组基础上口服尼可地尔。两组连续治疗6个月。比较两组心绞痛疗效、治疗前及治疗3、6个月后心绞痛相关指标(心绞痛发作次数、心绞痛持续时间、硝酸甘油用量)、心功能指标〔左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、脑钠肽(BNP)〕、炎症因子〔超敏C反应蛋白(hs-CRP)、可溶性细胞间黏附分子1(sICAM-1)、人软骨糖蛋白-39(YKL-40)〕及不良反应、主要不良心血管事件(MACE)发生率。结果 试验组心绞痛疗效优于对照组(P<0.05)。治疗方法与时间在心绞痛发作次数、心绞痛持续时间、硝酸甘油用量、LVEF、LVEDD、LVESD、BNP、hs-CRP、sICAM-1、YKL-40上存在交互作用(P<0.05);治疗方法、时间在心绞痛发作次数、心绞痛持续时间、硝酸甘油用量、LVEF、LVEDD、LVESD、BNP、hs-CRP、sICAM-1、YKL-40上主效应均显著(P<0.05);两组治疗3、6个月后心绞痛发作次数、硝酸甘油用量、LVEDD、LVESD、BNP、hs-CRP、sICAM-1、YKL-40分别小于本组治疗前,心绞痛持续时间分别短于本组治疗前,LVEF分别大于本组治疗前,治疗6个月后心绞痛发作次数、硝酸甘油用量、LVEDD、LVESD、BNP、hs-CRP、sICAM-1、YKL-40分别小于本组治疗3个月后,心绞痛持续时间分别短于本组治疗3个月后,LVEF分别大于本组治疗3个月后,且试验组治疗3、6个月后心绞痛发作次数、硝酸甘油用量、LVEDD、LVESD、BNP、hs-CRP、sICAM-1、YKL-40小于对照组,心绞痛持续�Objective To investigate the effect of nicorandil on efficacy of angina pectoris and inflammatory factors in elderly patients with type 2 diabetes mellitus(T2DM)combined with multiple coronary artery lesions.Methods A total of 84 elderly patients with T2DM combined with multiple coronary artery lesions admitted to the Shijiazhuang Second Hospital from June 2017 to September 2020 were selected and divided into control group and experimental group by simple random method,with 42 cases in each group.After admission,both groups received diabetes education and adopted a unified hypoglycemic plan.Under the above treatment plan,the control group received routine treatment,while the experimental group received oral nicorandil on the basis of the control group.Both groups were continuously treated for 6 months.Angina pectoris efficacy,related indexes of angina pectoris(number and duration of angina pectoris attacks,dosage of nitroglycerin),cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic dimension(LVESD),brain natriuretic peptide(BNP)],inflammatory factors[hypersensitive C-reactive protein(hs-CRP),soluble intercellular adhesion molecule-1(sICAM-1),human cartilage glycoprotein 39(YKL-40)]before treatment and after 3 and 6 months of treatment and incidence of adverse reactions and major adverse cardiovascular events(MACE)were compared between the two groups.Results The curative effect of angina pectoris of the experimental group was better than that of the control group(P<0.05).There was an interaction between treatment method and time on the number of angina pectoris attacks,the duration of angina pectoris attacks,the dosage of nitroglycerin,LVEF,LVEDD,LVESD,BNP,hs-CRP,sICAM-1 and YKL-40(P<0.05).The main effects of treatment method and time on the number of angina pectoris attacks,the duration of angina pectoris attacks,the dosage of nitroglycerin,LVEF,LVEDD,LVESD,BNP,hs-CRP,sICAM-1 and YKL-40 were all significant(P<0.05).After 3

关 键 词：糖尿病 2型 冠状动脉疾病 冠状动脉多支病变 心绞痛 尼可地尔 治疗效果 炎症 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学]