尼可地尔对心脏X综合征的疗效及对血管内皮功能的影响

Efficacy of Nicorandil for Treating the Patients With Cardiac Syndrome X and Its Impact on Vascular Endothelial Function

目的:观察尼可地尔治疗心脏X综合征的临床疗效及其对血管内皮功能的影响。方法:对140例心脏X综合征患者按照随机数字表随机分组,对照组70例给予常规抗心绞痛药物治疗,尼可地尔组70例在常规治疗基础上加用尼可地尔口服。患者均行静息心肌核素扫描(ECT)和平板运动试验检查,检测治疗前后(随访3个月)血浆内皮素(ET-1)、血清高敏C反应蛋白(hs-CRP)及一氧化氮(NO)水平变化。结果:尼可地尔组和对照组患者治疗后心绞痛发作频率和ECT阳性率均较治疗前降低(P<0.05)。尼可地尔组治疗后心电图平板运动试验可疑阳性率及阳性率较治疗前明显下降,差异有统计学意义(P<0.05);治疗后尼可地尔组较对照组心电图平板运动试验可疑阳性率及阳性率明显降低,差异均有统计学意义(P均<0.05)。血清学指标结果显示:治疗后对照组、尼可地尔组的ET-1、hs-CRP水平较治疗前均下降,而NO水平均上升,差异均有统计学意义(P均<0.05);治疗后两组间比较ET-1、hs-CRP和NO水平差异均有统计学意义(P均<0.05)。结论:尼可地尔通过抑制炎症因子、改善血管内皮功能机制来改善微血管性心绞痛症状,提高运动耐量,且疗效显著。

Objective： To observe the clinical efficacy of nicorandil for treating the patient with cardiac syndrome X （CSX） and its impact on vascular endothelial function. Methods： A total of 140 CSX patients were randomly divided into 2 groups： Control group, the patients received conventional anti-angina therapy and Nicorandil group, based on conventional anti-angina therapy, the patients received additional oral nicorandil treatment, n=70 in each group. All patients received resting emission computed tomography （ECT） and treadmill exercise ECG stress test （TET）. Blood levels of endothelin （ET-1）, high-sensitivity C-reactive protein （hs-CRP） and nitric oxide （NO） were examined before and 3 months after treatment. Results： Compared with pre-treatment condition, the attack frequency of angina pectoris and positive rate of ECT were decreased after treatment in both groups, P〈0.05; in Nicorandil group, the suspicious positive rate and positive rate of TET were reduced after treatment, P〈0.05. Compared with Control group, Nicorandil group had the much lower suspicious positive rate and positive rate of TET after treatment, P〈0.05. Blood tests indicated that compared with pre-treatment condition, ET-1 and hs-CRP were decreased, NO was increased after treatment in both groups, all P〈0.05; blood levels of ET-1, hs-CRP and NO were different between 2 groups after treatment, all P〈0.05. Conclusion： Nicorandil could inhibit inflammatory factors, elevate endothelial function and therefore improve micro