尼可地尔联合瑞舒伐他汀治疗老年急性冠脉综合征临床观察  

Clinical Observation of Nicorandil Combined with Rosuvastatin in the Treatment of Elderly Patients with Acute Coronary Syndrome

作　　者：高虹 张艳[1] 陈芳[1] 王林 蔡桂敏 贝宁[1] GAO Hong;ZHANG Yan;CHEN Fang;WANG Lin;CAI Guimin;BEI Ning(Hainan Provincial Cadre Sanatorium·Hainan Provincial Geriatric Hospital,Haikou,Hainan,China 571100)

机构地区：[1]海南省干部疗养院·海南省老年病医院,海南海口571100

出　　处：《中国药业》2023年第15期93-96,共4页China Pharmaceuticals

基　　金：海南省自然科学基金面上项目[818MS163]。

摘　　要：目的探讨尼可地尔联合瑞舒伐他汀治疗老年急性冠脉综合征(ACS)的临床疗效,以及对患者冠状动脉微循环及血管内皮因子水平的影响。方法选取医院内科2020年10月至2022年10月收治的老年ACS患者120例,根据用药方案的不同分为对照组(57例)和观察组(63例)。对照组在基础治疗上加用瑞舒伐他汀,观察组在对照组治疗基础上加用尼可地尔,均治疗6个月。结果观察组治疗总有效率为96.83%,显著高于对照组的84.21%(P<0.05)。治疗后,两组患者的三酰甘油(TG)、总胆固醇(TC)水平、血管内皮生长因子(VEGF)、内皮素-1(ET-1)水平及循环抵抗指数(IMR)、冠状动脉血流储备指数(CFR)均较治疗前显著改善(P<0.05),且观察组TG,TC,ET-1水平均显著低于对照组(P<0.05),IMR,CFR,VEGF水平均显著高于对照组(P<0.05)。对照组和观察组患者恶心、厌食发生率相当(7.02%比9.52%,P>0.05)。结论尼可地尔联合瑞舒伐他汀治疗老年ACS的临床疗效良好,可改善患者的冠状动脉微循环及血管内皮因子水平,且安全性良好。Objective To investigate the clinical efficacy of nicorandil combined with rosuvastatin in the treatment of elderly patients with acute coronary syndrome(ACS),and its effect on coronary microcirculation and vascular endothelial factor levels.Methods A total of 120 elderly patients with ACS admitted to the Department of Internal Medicine of the hospital from October 2020 to October 2022 were selected and divided into the control group(57 cases)and the observation group(63 cases)according to different medication regimens.On the basis of the basic treatment,the patients in the control group were treated with rosuvastatin,and the patients in the observation group were treated with nicorandil on the basis of the control group.Both groups were treated for six months.Results The total effective rate in the observation group was 96.83%,which was significantly higher than 84.21%in the control group(P<0.05).After treatment,the levels of triglyceride(TG),total cholesterol(TC),vascular endothelial growth factor(VEGF),and endothelin-1(ET-1),index of micro-circulatory resistance(IMR),coronary flow reserve(CFR)indexes in the two groups were significantly better than those before treatment(P<0.05),and the levels of TG,TC,and ET-1 in the observation group were significantly lower than those in the control group(P<0.05),while the IMR,CFR and the level of VEGF in the observation group were significantly higher than those in the control group(P<0.05).The incidence of nausea and anorexia in the control group was comparable to that in the observation group(7.02%vs.9.52%,P>0.05).Conclusion Nicorandil combined with rosuvastatin has good clinical efficacy and safety in the treatment of elderly patients with ACS,which can improve coronary microcirculation and vascular endothelial factor levels in patients.

关 键 词：尼可地尔 瑞舒伐他汀 急性冠脉综合征 冠状动脉微循环 

分 类 号：R696.4[医药卫生—泌尿科学] R972.6[医药卫生—外科学]