大剂量瑞舒伐他汀钙联合尼可地尔对老年冠心病合并糖尿病PCI术后患者疗效观察及对肾功能影响

Effect of high dose rosuvastatin calcium combined with nicorandil on renal function in elderly patients with coronary heart disease complicated with diabetes mellitus after percutaneous coronary intervention

目的:探讨大剂量瑞舒伐他汀钙联合尼可地尔对老年冠心病合并糖尿病经皮冠状动脉介入(PCI)术后患者疗效观察及对肾功能的影响。方法:选取某院行经皮冠状动脉介入术治疗的老年冠心病合并糖尿病患者108例,按照随机数字表法分为观察组和对照组各54例。对照组采用尼可地尔治疗,观察组在对照组基础上联合瑞舒伐他汀钙片治疗,2组均连续治疗4周,治疗结束后对2组患者随访6个月。比较2组患者临床疗效、治疗前后心功能、肾功能及心血管不良事件发生率。结果:治疗总有效率观察组(88.89%)高于对照组(72.22%),2组比较差异有统计学意义(P<0.05);治疗后2组患者左室舒张末期内径(LVEDD)、血浆脑钠肽(BNP)水平下降,左室射血分数(LVEF)水平升高,且观察组LVEDD、BNP水平低于对照组,LVEF水平高于对照组,2组比较差异有统计学意义(P<0.05);治疗后2组患者肌酐(Cr)、膀抑素C(CysC)水平下降,肾小球滤过率(GFR)水平升高,2组比较差异有统计学意义(P<0.05);心血管不良事件发生率观察组(9.26%)低于对照组(29.63%),差异有统计学意义(P<0.05)。结论:老年冠心病合并糖尿病PCI术后患者给予大剂量瑞舒伐他汀钙联合尼可地尔治疗效果显著,能有效改善心脏功能,促进患者肾功能恢复,并能降低心血管不良事件的发生,有较高的临床应用价值。

Objective:To investigate the effect of high dose rosuvastatin calcium combined with nicorandil on renal function in elderly patients with coronary heart disease and diabetes mellitus after percutaneous coronary intervention(PCI).Methods:108 elderly patients with coronary heart disease and diabetes mellitus who underwent PCI were selected and randomly divided into an observation group and a control group,54 cases in each.The control group was treated with nicorandil,while the observation group was treated with rosuvastatin calcium tablets on the basis of the control group.Both groups were treated continuously for 4 weeks.After the treatment,the patients in the two groups were followed up for 6 months.Clinical curative effect,improvement of cardiac function and renal function before and after the treatment were compared between the two groups,and the occurrence of cardiovascular adverse events in the two groups was recorded.Results:The total effective rate of the observation group(88.89%)was higher than that of the control group(72.22%)(P<0.05).After the treatment,the levels of LVEDD and BNP decreased and the levels of LVEF increased in the two groups.The levels of LVEDD and BNP in the observation group were lower than those in the control group,and the levels of LVEF in the observation group were higher than those in the control group(P<0.05).After the treatment,the levels of Cr and CysC decreased and GFR increased in the two groups,and the difference between the two groups was significant(P<0.05).The total incidence of cardiovascular adverse events in the observation group(9.26%)was lower than that in the control group(29.63%)(P<0.05).Conclusion:Large dose of rosuvastatin calcium combined with nicorandil is effective in treatment of elderly patients with coronary heart disease complicated with diabetes after PCI.It can improve heart function,promote recovery of renal function,and reduce the occurrence of cardiovascular adverse events.It has high clinical value.