尼可地尔联合琥珀酸美托洛尔治疗冠心病心绞痛的效果及安全性分析  

Analysis of therapeutic effect and safety of nicorandil combined with metoprolol succinate for treating coronary heart disease angina pectoris

作　　者：王振良 孟中华 刘江峰 WANG Zhenliang;MENG Zhonghua;LIU Jiangfeng(Department of General Medicine,Xinxiang First People’s Hospital,the Fifth Clinical College of Xinxiang Medical University,Xinxiang Henan 453000,China)

机构地区：[1]新乡市第一人民医院/新乡医学院第五临床学院全科医学科,河南新乡453000

出　　处：《实用心电与临床诊疗》2025年第1期71-75,共5页PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT

摘　　要：目的探讨尼可地尔联合琥珀酸美托洛尔治疗冠心病心绞痛的效果及安全性。方法回顾性选取196例冠心病心绞痛患者为研究对象,根据治疗方案的不同将其分为对照组(n=98,给予琥珀酸美托洛尔治疗)和观察组(n=98,给予尼可地尔联合琥珀酸美托洛尔治疗)。两组均连续用药8周。比较两组的临床疗效,以及治疗前后的心绞痛发作情况(持续时间、发作次数),心率及血压,血液流变学指标[纤维蛋白原(fibrinogen,FIB)、低切全血黏度(low-shear whole blood viscosity,LWBV)、血浆黏度、高切全血黏度(high-shear whole blood viscosity,HWBV)],血清炎症介质[核因子-κB(nuclear factor-κB,NF-κB)、白细胞介素-18(interleukin-18,IL-18)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、几丁质酶-3样蛋白-1(chitinase-3-like protein 1,CHI3L1,也称为YKL-40)]水平和不良反应发生率。结果观察组总有效率较对照组高(P<0.05)。与对照组相比,观察组治疗后心绞痛发作次数更少、发作持续时间更短(均P<0.01)。观察组治疗后收缩压、舒张压、心率较对照组低,LWBV、血浆黏度、HWBV、FIB水平降低幅度大于对照组,血清IL-18、NF-κB、hs-CRP、YKL-40水平均低于对照组(均P<0.01)。观察组与对照组不良反应发生率比较,差异无统计学意义(P>0.05)。结论尼可地尔联合琥珀酸美托洛尔治疗冠心病心绞痛效果优于单一用药组。联合用药可有效改善患者心绞痛发作情况、血液流变学指标,降低心率、血压、血清炎症介质水平,且安全可靠。Objective To investigate the therapeutic effect and safety of nicorandil combined with metoprolol succinate for treating patients with coronary heart disease angina pectoris.Methods We retrospectively selected 196 patients with coronary heart disease angina pectoris as research subjects.They were divided into control group(n=98,treated with metoprolol succinate),and observation group(n=98,treated with nicorandil and metoprolol succinate)according to different treatment plans.Both groups received continuous medication for 8 weeks.We compared the clinical efficacy,incidence of adverse reactions,and the attacks of angina pectoris(its duration and frequency),heart rate and blood pressure,hemorheology indexes[fibrinogen(FIB),low-shear whole blood viscosity(LWBV),plasma viscosity(PV)and high-shear whole blood viscosity(HWBV)]and serum inflammatory mediators[nuclear factor-κB(NF-κB),interleukin-18(IL-18),high-sensitivity C-reactive protein(hs-CRP)and chitinase-3-like protein 1(CHI3L1,also known as YKL-40)]levels before and after treatment between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).Compared with the control group,patients in the observation group had fewer episodes of angina pectoris and shorter attack duration after treatment(both P<0.01).Among the patients of the observation group,their systolic and diastolic blood pressure,and heart rate were lower than those of the control group after treatment;the reduction amplitued of LWBV,PV,HWBV,and FIB levels in the observation group after treatment was greater than those in the control group;the levels of serum IL-18,NF-κB,hs-CRP,and YKL-40 in the observation group were lower than those in the control group after treatment(all P<0.01).There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion The efficacy of nicorandil combined with metoprolol succinate in the treatment of patients with co

关 键 词：冠心病 心绞痛 尼可地尔 琥珀酸美托洛尔 疗效 

分 类 号：R541.4[医药卫生—心血管疾病]