尼可地尔联合辅酶Q_(10)治疗慢性心力衰竭的临床效果

Clinical effect of Nicorandil combined with Coenzyme Q_(10) in the treatment of chronic heart failure

目的探讨尼可地尔联合辅酶Q_(10)治疗慢性心力衰竭的应用效果。方法选取2018年10月至2020年11月北京王府中西医结合医院收治的80例慢性心力衰竭患者作为研究对象,采用随机数字表法将患者分为对照组和试验组,每组40例。两组均进行心力衰竭的常规治疗,对照组给予辅酶Q_(10),试验组在对照组基础上给予尼可地尔。治疗4个月后,比较两组患者的6 min步行距离(6MWD)、静息心率(HR)、左心室射血分数(LVEF)、超氧化物歧化酶(SOD)、C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、血清脑钠肽(BNP)的变化及不良反应发生情况。结果治疗前两组的6MWD、HR、LVEF比较,差异无统计学意义(P>0.05);治疗后试验组的6MWD长于对照组,HR低于对照组,LVEF高于对照组,差异有统计学意义(P<0.05)。治疗前两组的SOD、TNF-α、CRP、BNP比较,差异无统计学意义(P>0.05);治疗后试验组SOD水平高于对照组,TNF-α、CRP、BNP水平低于对照组,差异有统计学意义(P<0.05)。治疗后试验组患者心功能分级优于对照组,治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论尼可地尔联合辅酶Q10可以降低慢性心力衰竭患者血清中炎症细胞因子水平改善氧化应激状态,治疗效果较好具有较高的临床应用价值。

Objective To investigate the effect of Nicorandil combined with Coenzyme Q_(10) in patients with chronic heart failure.Methods A total of 80 patients with chronic heart failure admitted to Beijing Wangfu Hospital of Integrated Traditional Chinese and Western Medicine from October 2018 to November 2020 were selected as the research subjects.The patients were divided into control group and experimental group by random number table method,with 40 patients in each group.Both groups received conventional treatment of heart failure,the control group was given Coenzyme Q_(10),the experimental group was given Nicorandil based on the control group.After 4 months of treatment,the changes of 6 min walking distance(6MWD),resting heart rate(HR),left ventricular ejection fraction(LVEF),superoxide dismutase(SOD),C-reactive protein(CRP),tumor necrosis factor(TNF-α),serum brain natriuretic peptide(BNP)and the incidence of adverse reactions were compared between two groups.Results There were no significant differences in 6MWD,HR and LVEF between the two groups before treatment(P>0.05).After treatment,6MWD of the experimental group was longer than that of the control group,HR was lower than that of the control group,and LVEF was higher than that of the control group,with statistically significant differences(P<0.05).There were no significant differences in SOD,TNF-α,CRP and BNP between the two groups before treatment(P>0.05).After treatment,SOD level in experimental group was higher than control group,TNF-α,CRP and BNP levels were lower than control group,the differences were statistically significant(P<0.05).After treatment,the grading of cardiac function in experimental group was better than that in control group,the total effective rate was higher than that of control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Nicorandil combined with Coenzyme Q_(10) can reduce the level of serum inflammatory cytokines and improve the state of oxidative stress in patients with chronic heart failure.