烟酸注射液联合硝酸甘油治疗不稳定型心绞痛的临床研究

Clinical study on Nicotinic Acid Injection combined with nitroglycerin in treatment of unstable angina pectoris

目的探讨烟酸注射液联合硝酸甘油注射液治疗不稳定型心绞痛的临床疗效。方法回顾性分析2019年2月—2023年2月在西安交通大学附属红会医院治疗的118例不稳定型心绞痛患者的临床资料。根据用药种类的不同分为对照组和治疗组,每组各59例。对照组静脉输入硝酸甘油注射液,20 mL加入5%葡萄糖注射液50 mL,初始剂量5μg/min,根据病情调整剂量,1次/d;在此基础上,治疗组肌肉注射烟酸注射液,100 mg/次,5次/d。两组患者均进行7 d治疗。观察两组患者临床疗效,比较治疗前后两组患者心绞痛发作次数及持续时间,血凝素样氧化低密度脂蛋白受体1(Lox-1)、I型胶原吡啶交联终肽(ICTP)、心肌营养素-1(CT-1)、血栓烷素B2(TXB2)、B淋巴细胞瘤/白血病-2(Bcl-2)、脂联素(APN)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、肌酸激酶(CK)、α-羟基丁酸脱氢酶(HBDH)、肌酸激酶同功酶(CK-MB)和乳酸脱氢酶(LDH)水平。结果治疗后,治疗组临床有效率(98.31%)明显高于对照组(81.36%,P<0.05)。治疗后,两组心绞痛发作次数、每次持续时间均减少(P<0.05),且治疗组减少最显著(P<0.05)。治疗后,两组患者血清Lox-1、ICTP、CT-1、TXB2、TC、TG、LDL-C、CK、HBDH、CK-MB和LDH水平均明显下降,而Bcl-2、APN、HDL-C水平明显增高(P<0.05),且治疗组这些指标比对照组改善更明显(P<0.05)。结论烟酸注射液联合硝酸甘油注射液治疗不稳定型心绞痛可有效缓解临床症状,促进心功能、血脂、血清细胞因子水平改善。

Objective To explore the clinical efficacy of Nicotinic Acid Injection combined with nitroglycerin in treatment of unstable angina pectoris.Methods Patients(118 cases)with unstable angina pectoris in Honghui Hospital Affiliated to Xi'an Jiaotong University from February 2019 to February 2023 were divided into control and treatment group based on different treatments,and each group had 59 cases.Patients in the control group were iv administered with Nitroglycerin Injection,20 mL added into 5%glucose injection 50 mL,the initial dose was 5μg/min,adjusted the dose according to the condition,once dayly.Patients in the treatment group were intramuscular injection administered with Nicotinic Acid Injection on the basis of the control group,100 mg/time,five times daily.Patients in two groups were treated for 7 d.After treatment,the clinical evaluation was evaluated,and the frequency and duration of angina pectoris,the levels of Lox-1,ICTP,CT-1,TXB2,Bcl-2,APN,TC,TG,LDL-C,HDL-C,CK,HBDH,CK-MB and LDH in two groups before and after treatment were compared.Results After treatment,the clinical effective rate of the treatment group(98.31%)was significantly higher than that of the control group(81.36%,P<0.05).After treatment,the attack times and duration of angina pectoris were significantly decreased in two groups(P<0.05),and which in the treatment group decreased more significant than that in the control group(P<0.05).After treatment,the serum levels of Lox-1,ICTP,CT-1,TXB2,TC,TG,LDL-C,CK,HBDH,CK-MB and LDH were significantly decreased,while the levels of Bcl-2,APN and HDL-C were significantly increased in two groups(P<0.05),and the improvement of these indexes in the treatment group was more obvious than that in the control group(P<0.05).Conclusion Nicotinic Acid Injection combined with nitroglycerin can effectively relieve clinical symptoms and improve cardiac function,blood lipids and serum cytokines in treatment of unstable angina pectoris.