尼可地尔对老年不稳定型心绞痛患者心绞痛持续时间、频率及血清ET、NO、cTnT的影响

Effects of Nicorandil on Duration and Frequency of Angina Pectoris and Serum ET,NO,cTnT in Elderly UAP Patients

目的观察尼可地尔对老年不稳定型心绞痛(unstable angina pectoris,UAP)患者对心绞痛持续时间、频率及血清内皮素(endothelin,ET)、一氧化氮(nitric oxide,NO)、肌钙蛋白T(troponin,cTnT)的影响。方法选取2021年6月至2022年6月收治的280例老年UAP患者为研究对象,采用随机数字法分为两组,每组140例。两组患者均给予常规治疗,对照组予口服硝酸异山梨酯,10 mg,tid;观察组予口服尼可地尔,5 mg,tid;两组连续治疗36周。比较两组治疗前和治疗36周后血小板活化功能、ET、NO、cTnT、血脂、血流变、心功能及心绞痛情况,比较两组治疗36周后心电图变化情况和安全性。结果两组治疗前血小板活化功能、ET、NO、cTnT、血脂比较,差异无统计学意义(P>0.05);与治疗前比较,两组治疗36周后血小板CD62P、ET、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol肌钙蛋白,LDL-C)、活化血小板糖基化复合物(platelet activated complex-1,PAC-1)、cTnT、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)降低,且观察组更低(P<0.05);两组治疗36周后NO、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)升高,且观察组更高(P<0.05)。两组治疗前心绞痛持续时间、血流变比较,差异无统计学意义(P>0.05);与治疗前相比,两组治疗36周后心绞痛持续时间、频率及全血黏度、血浆黏度、纤维蛋白原、红细胞沉降率降低,且观察组更低(P<0.05)。观察组总有效率(92.14%)高于对照组(82.14%),差异有统计学意义(P<0.05)。结论尼可地尔治疗老年UAP可改善患者血流变指标,调节血脂,抑制血小板的活化,减少心绞痛持续时间。

Objective To observe the effects of Nicorandil on the duration and frequency of angina pectoris and serum endothelin(ET),nitric oxide(NO) and troponin T(cTnT).Methods 280 elderly UAP patients admitted to our hospital from June 2021 to June 2022 were selected as the research objects.They were randomly divided into two groups,140 in a single group.The patients in both groups were given routine treatment.The control group was given isosorbide dinitrate,10mg,tid orally,and the observation group was given nicorandil,5mg,tid orally,for 36 consecutive weeks.The differences of platelet activation function,ET,NO,cTnT,blood lipid,hemorheology and angina pectoris between the two groups before and after 36 weeks of treatment were compared.Results There was no significant difference in platelet activation function,ET,NO,cTnT and blood lipid between the two groups before treatment(P >0.05).Compared with before treatment,after 36 weeks of treatment,the platelet granule surface facial mask glycoprotein(CD62P),ET,low-density lipoprotein cholesterol(LDL-C),activated platelet glycosylation complex(PAC-1),cTnT,total cholesterol(TC),triglyceride(TG),decreased in both groups,and lower in the observation group(P <0.05);After 36 weeks of treatment,NO and high-density lipoprotein cholesterol(HDL-C) increased in both groups,and higher in the observation group(P <0.05).There was no significant difference in angina pectoris and hemorheology between the two groups before treatment(P >0.05).Compared with that before treatment,the duration,frequency,whole blood viscosity,plasma viscosity,fibrinogen and erythrocyte sedimentation rate of angina pectoris in the two groups decreased after 36 weeks of treatment,and the observation group was lower(P <0.05).The total effective rate of the observation group was 92.14%,which was higher than that of the control group(82.14%,P<0.05).Conclusion Nicorandil can improve hemorheology index,regulate blood lipid,inhibit platelet activation and relieve angina pectoris in elderly patients with UAP.