替格瑞洛联合比索洛尔治疗冠心病不稳定型心绞痛患者的效果观察

Effect of ticagrelor combined with bisoprolol on patients with unstable angina pectoris of coronary heart disease

目的:探讨替格瑞洛联合比索洛尔对冠心病不稳定型心绞痛患者血管内皮功能及心率变异性的影响。方法:选取78例冠心病不稳定型心绞痛患者,按照随机数字表法分成对照组和观察组,每组各39例。对照组采用替格瑞洛治疗,观察组采用替格瑞洛联合比索洛尔治疗。比较两组血管内皮功能[血管细胞黏附因子-1(VCAM-1)、内皮细胞特异性分子-1(ESM-1)及血管紧张素Ⅱ(AngⅡ)]及心率变异性指标[连续正常R-R间期差值的均方(RMSSD)、24 h内每5 min一段的平均正常R-R间期值的标准差(SDANN)、24 h平均R-R间期标准差(SDNN)]的变化。结果:治疗后两组患者VCAM-1、ESM-1及AngⅡ水平均低于治疗前,且观察组低于对照组,两组比较差异有统计学意义(P<0.05);治疗后,两组RMSSD、SDANN、SDNN水平均高于治疗前,且观察组高于对照组,两组比较差异有统计学意义(P<0.05)。结论:替格瑞洛联合比索洛尔治疗可改善冠心病不稳定型心绞痛患者血管内皮功能,可调节心率变异性。

Objective: To investigate the effect of ticagrelor combined with bisoprolol on the vascular endothelial function and heart rate variability in patients with unstable angina pectoris of coronary heart disease. Methods: A total of 78 patients with unstable angina pectoris of coronary heart disease were randomized into the control group and observation group, each with 39 cases. The control group were treated with ticagrelor, while the observation group were treated with the combined ticagrelor and bisoprolol. Then the vascular endothelial function [vascular cell adhesion factor-1(VCAM-1), endothelial cell specific molecule-1(ESM-1)and angiotensin II(AngⅡ)] and heart rate variability indicators [continuous normal RR Changes in the mean square of the interval difference(RMSSD), the standard deviation of the average normal RR interval value(SDANN)every 5 minutes within 24 h and the standard deviation of the average RR interval(SDNN)in 24 h were compared between the two groups]. Results: After treatment, the VCAM-1, ESM-1 and Ang II levels of the two groups were lower than those before treatment, and the observation group’s VCAM-1, ESM-1 and Ang II levels was lower than those of the control group, and the difference were statistically significant(P<0.05);and the RMSSD, SDANN, and SDNN levels of the two groups were higher than those before treatment, and the observation group’s RMSSD, SDANN, and SDNN levels was higher than those of the control group, the difference was statistically significant(P<0.05). Conclusion: The combined treatment of Tigrelor with bisoprolol can improve the vascular endothelial function and regulate heart rate variability in patients with unstable angina pectoris of coronary heart disease.