尼可地尔联合低剂量替格瑞洛对老年微血管病性心绞痛患者血管内皮功能及炎症因子的影响

The effects of nikodil on vascular endothelial function and inflammatory factors in patients with microvascular disease in elderly patients with low dose tigliellol

目的探讨尼可地尔联合低剂量替格瑞洛对老年微血管病性心绞痛患者血管内皮功能及炎症因子的影响。方法前瞻性研究选取2016年8月～2017年8月在沈阳市第十人民医院心血管内科进行治疗的160例老年微血管病性心绞痛患者,按随机数表法分为对照组和试验组各80例,对照组行常规药物治疗,试验组在对照组基础上给予尼可地尔(5 mg,3次/d,口服)联合低剂量替格瑞洛(60 mg,2次/d,口服)治疗。所有患者治疗前后均检查血常规、血生化、尿常规、粪常规、心电图并记录结果。记录心绞痛发病次数,观察治疗前后患者心绞痛临床变化;检测患者治疗前后血管内皮依赖性舒张变化率(FMD)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、基础动脉内径值和袖带充气施加压力时的充气后动脉内径值,比较两组治疗效果。结果治疗后,对照组总有效率为70.0%,试验组总有效率为91.25%,差异有统计学意义(P <0.05)。两组治疗后基础动脉内径值、充气后动脉内径值、FMD值均显著增高,且试验组显著高于对照组,差异有统计学意义(P <0.05)。两组治疗后CRP值、TNF-α值均显著降低,且试验组显著低于对照组,差异有统计学意义(P <0.05)。所有患者血、尿、粪常规及心电图均未出现显著异常,两组治疗方法均安全。结论尼可地尔联合低剂量替格瑞洛可以显著改善老年微血管病性心绞痛患者血管内皮功能,减轻一系列炎症反应。

Objective To explore the effect of nikodil on vascular endothelial function and inflammatory factors in patients with microvascular disease in elderly patients with low dose tigrel. Methods Select 160 elderly patients with microangiopathy and angina pectoris treated at the Department of Cardiology in our hospital from August 2016 to August 2017. According to random number table method is divided into control group and experimental group 80 cases,control group routine drug treatment,the experimental group in the control group on the basis of given nicole,(5 mg/dar,Po) in combination with low dose for Greg lowe (60 mg/bid,Po) treatment. All patients were examined for routine blood routine,blood biochemistry,urine routine,fecal routine,ecg and recorded results before and after treatment. We record the incidence of angina pectoris,and observe the clinical changes of angina pectoris before and after treatment. The results showed that patients with FMD,CRP,TNF- alpha,the internal diameter of the underlying artery,and the inflating posterior arterial diameter of the cuff were compared with those of the two groups. Results After treatment,the total effective rate of the control group was 70.0%,and the total effective rate of the test group was 91.25%(P < 0.05);the internal diameter of the basic artery,the internal diameter of the artery and the FMD value of the two groups were significantly increased(P < 0.05);the three index values of the experimental group were significantly higher than that of the control group(P < 0.05);both CRP values and TNF- alpha were significantly reduced in both groups(P < 0.05);the CRP value of the test group and TNF- alpha were significantly lower than that in the control group(P < 0.05). There were no significant abnormalities in blood,urine,fecal routine and ecg in all patients,and both groups were safe. Conclusion Nikodil combined with low dose tigliellol could significantly improve the vascular endothelial function in elderly patients with microvascular disease and reduce a series of inflammatory responses.