尼可地尔联合麝香保心丸对冠脉三支病变患者的影响

Effect of nicodl and Shexiang Baoxin Pill on patients with three lesions of coronary vessels patients with

目的探讨尼可地尔联合麝香保心丸(SBP)对冠脉三支病变患者中性粒细胞与淋巴细胞比值(NLR)、单核细胞与高密度脂蛋白胆固醇比值(MHR)及生活质量的影响。方法选取2019年1月—2021年6月我院收治的不稳定型心绞痛患者320例,随机分为观察组和对照组,每组160例。两组均给予抗血小板聚集、他汀类、β受体阻滞剂等药物治疗,对照组给予尼可地尔口服,每次5 mg,每日3次。观察组在对照组基础上加用SBP口服,每次2粒,每日3次。治疗2个月。分别于治疗前后检测血清中性粒细胞绝对数(N)、淋巴细胞绝对数(L)、单核细胞(M)、高密度脂蛋白(HDL)、内皮素-1(ET-1)、一氧化氮(NO)、丙二醛(MAD)、超氧化物歧化酶(SOD)水平,计算NLR和MHR;比较两组治疗前后心绞痛发作频率、持续时间、6 min步行试验(6 MWT)的步行距离及总有效率;采用西雅图心绞痛量表(SAQ)、简明健康状况调查表(SF-36)对患者生活质量进行评估。结果治疗后,两组患者心绞痛发作频率、持续时间、NLR、MHR、ET-1、MAD水平较治疗前降低,6 MWT、NO、SOD含量较治疗前升高(P<0.05);观察组患者上述指标改善程度明显优于对照组(P<0.01);观察组总有效率明显高于对照组(χ^(2)=5.129,P=0.016)。治疗后,两组患者SAQ、SF-36评分较治疗前明显升高,且观察组SAQ、SF-36评分较对照组明显升高(P<0.01)。两组不良反应发生率比较,差异无统计学意义(χ^(2)=1.920,P=0.124)。随访6个月,观察组患者MACE发生率较对照组明显降低(χ^(2)=4.728,P=0.022)。结论尼可地尔联合SBP抑制炎症反应,改善氧化应激和血管内皮功能,缓解心绞痛症状,提高患者生活质量,降低主要心血管不良事件发生率。

Objective To study the efficacy of nicdil combined with Shexiang Baoxin Pill(SBP)in three coronary vascular lesions and its effect on quality of life.Methods A total of 320 patients with unstable angina admitted to our hospital from January 2019 to June 2021 were selected and randomly divided into 160 patients each in the treatment and control group.Both groups were treated with antiplatelet aggregation,statin,receptor blockers,and the control group received Nicoxidil,orally at 5 mg,3 times a day.The observation group added SBP orally according to the control group,with 2 grains per time,three times a day.Treatment was continued for 2 months.The levels of absolute serum neutrophils number(N),absolute lymphocyte number(L),endothelin 1(ET-1),nitric oxide(NO),malondialdehyde(MAD),superoxide dismutase(SOD),and soluble growth stimulation expression gene 2 protein(sST2)were measured before and after treatment,Neutrophil-to-lymphocyte ratio(NLR)was calculated;Observe the frequency and duration of angina attacks,and the walking distance of the 6 min walk test(6MWT)before and after treatment;Patient quality of life was assessed using the Seattle Angina Scale(SAQ)and the Brief Health Survey(SF-36).Results After treatment,the frequency,duration of angina pectoris attacks,NLR,MHR,ET-1 and MAD were decreased compared with treatment,and 6 MWT,NO and SOD were increased compared with treatment(P<0.05).The treatment group improved significantly better than the control group(P<0.01).The total efficiency was significantly higher than the control group(χ^(2)=5.129,P=0.016).After treatment,the SAQ and SF-36 scores were significantly higher compared with before treatment,and the SAQ and SF-36 scores were significantly higher compared with the control group(P<0.01).The incidence of adverse effects between the two groups was not significant(χ^(2)=1.920,P=0.124).After 6 months of follow-up,the incidence of major cardiovascular adverse events was significantly lower compared with the control group(χ^(2)=4.728,P=0.022).Conclusion Nicdil combined with SBP improves vascular endothelial function,inhibit oxidative stress and inflammatory response,relieve angina symptoms,improve patient quality of life,and reduce the incidence of major cardiovascular adverse events.