硝酸异山梨酯片联合美托洛尔治疗老年冠心病心绞痛的疗效及对IL-18及hs-CRP水平的影响

Clinical Effect of Isosorbide Dinitrate Tablets Combined with Metoprolol on Senile Patients with Angina Pectoris and its Influence on IL-18 and hs-CRP Levels

目的:观察硝酸异山梨酯片联合美托洛尔治疗老年冠心病心绞痛的临床效果,观察联合用药对患者血浆白介素-18(Interleukin,IL-18)、超敏C反应蛋白(High sensitivity C reactive protein,hs-CRP)的影响。方法:选择本院收治的老年冠心病心绞痛患者84例,随机分为研究组和对照组,各42例,研究组给予硝酸异山梨酯片20 mg,3次/d,口服,美托洛尔12.5mg,1次/d,口服;对照组仅给予硝酸异山梨酯片20 mg,3次/d,口服,疗程均为28d。观察两组用药后心绞痛改善情况,并观察两组治疗前后血清IL-8、hs-CRP变化。结果:治疗后,研究组总有效率为90.5%;对照组总有效率为69.0%,研究组总有效率明显高于对照组(P<0.01)。治疗后两组心率、心绞痛发作频率明显降低,持续时间明显缩短(P<0.05);研究组心率、心绞痛发作频率明显低于对照组,持续时间也较对照组短(P<0.05)。治疗前两组血浆IL-18、hs-CRP水平比较无统计学差异(P>0.05);治疗后研究组IL-18、hs-CRP水平明显低于对照组(P<0.05)。结论:硝酸异山梨酯片联合美托洛尔治疗老年冠心病心绞痛能够进一步减轻患者IL-18、hs-CRP水平,对心绞痛治疗效果较单独应用酸异山梨酯片更佳。

Objective： To investigate the clinical effect of isosorbide dinitrate tablets combined with metoprolol on senile patients with angina pectoris and its influence on IL-18 and hs-CRP levels. Methods： 84 elderly patients with coronary heart disease and angina pectoris were randomly divided into study group and control group, each 42 cases, the study group were given isosorbide dinitrate tablets 20 mg, 3/d, oral, metoprolol 12.5mg, 1 /d, oral; the control group only received isosorbide dinitrate tablets 20 mg, 3/d, oral, treating for28d. We observed improvement of angina pectoris, and observed the changes of serum IL-8, hs-CRP of the two groups before and after treat- ment. Results： the total effective rate of the study group 90.5%; the total effective rate of the control group 69%, total effective rate of study group was higher than that ofcontrol group （P〈0.01）. After the treatment, heart rate, frequency of angina pectoris attack significantly reduced, the duration was significantly shorter （P〈0.05）; heart rate, frequency of angina pectoris attack of the study group was significant- ly lower than that of the control group, the duration is shorter than the control group （P〈0.05）. Before treatment 1L-18, hs-CRP level had no statistical difference （P〉0.05）; after treatment, hs-CRP, IL-18 was significantly lower than that in control group （P〈0.05）. Conclusion： Isosorbide dinitrate tablets combined with metoprolol on senile patients with coronary heart disease and angina pectoris can further re- duce IL-18, hs-CRP level of patients, therapeutic effect on angina is better.