烟酸注射液对非ST段抬高型急性冠脉综合征患者炎症反应的影响

Effects of niacin injection on inflammatory responses in patients with non-ST-elevation acute coronary syndrome

目的评价烟酸注射液对非ST段抬高型急性冠脉综合征(NSTE-ACS)患者的高敏感性C反应蛋白(hs-CRP)和胆固醇水平的影响。方法选取2012年1月至2016年12月就诊于本院的NSTE-ACS患者63例为研究对象,随机分为两组,对照组根据指南进行最佳治疗,观察组患者在对照组的基础上每天使用烟酸注射液进行治疗,连续治疗1个月。所有患者在治疗前和治疗后4周均行取血样测定hs-CRP、总胆固醇、低密度脂蛋白。并且对两组患者的短期心血管事件以及烟酸治疗的安全性进行评价。结果经过4周的治疗后,两组患者的LDL、TC、NTproBNP、ESR、CRP均较治疗前好转,观察组患者以上指标较对照组明显改善,差异具有统计学意义(P<0.05);对两组重新进行NYHA分级后,两组患者的分级比较差异具有统计学意义(P<0.05)。两组患者在早期临床事件如复发性心绞痛、心律失常比较差异无统计学意义。在1个月的随访中,两组均无死亡病例。观察组的2例患者出现肌肉疼痛,1例患者出现面色潮红,经过对症处理后症状均消失。结论烟酸注射液能成功降低患者的CRP和血脂参数,安全性较高,值得临床推广应用。

Objective To evaluate the effect of niacin injection on hs-CRP and cholesterol levels in patients with non-ST-elevation acute coronary syndrome(NSTE-ACS).Methods 63 patients admitted to our hospital for treatment of NSTE-ACS from January 2012 to December 2016 were selected as research objects,and randomly divided into two groups.The control group received the best treatment,and the observation group received niacin injection daily for 1 month on the basis of the control group.Blood samples were taken from all patients before and 30 days after treatment to determine hs-CRP,total cholesterol and LDL.Short-term cardiovascular events and the safety of niacin therapy were evaluated in both groups.Results After 4 weeks of treatment,LDL,TC,NT-proBNP,ESR,CRP in the two groups were better than before treatment.These indicators in the observation group were significantly improved compared with those in the control group,and the difference was statistically significant(P<0.05).There was statistically significant difference in patients'grades between the two groups after NYHA classification(P<0.05).The two groups were similar in early clinical events such as recurrent angina,arrhythmia and the differences were not statistically significant.One month of follow-up,no deaths occurred in either group.Muscle pain occurred in 2 patients in the observation group,and flushing occurred in 1 patient.All symptoms disappeared after symptomatic treatment.Conclusion Niacin injection can be used safely and successfully reduce crp and lipid parameters in patients.