辅酶Q10联合艾司洛尔对冠心病不稳定性心绞痛患者血脂水平及T淋巴细胞亚群的影响

Effects of Coenzyme Q10 Combined with Esmolol on Blood Lipid Levels and T Lymphocyte Subsets in Patients with Unstable Angina Pectoris of Coronary Heart Disease

目的 观察辅酶Q10联合艾司洛尔治疗冠心病不稳定性心绞痛患者的疗效及其对血脂水平、T淋巴细胞亚群的影响。方法 选取2021年1月至2023年1月惠济区人民医院收治的冠心病不稳定性心绞痛患者116例为研究对象,依据随机单双数分配原则分为单一组58例(艾司洛尔治疗)、联合组58例(辅酶Q10联合艾司洛尔治疗)。观察两组临床疗效,心功能[左室舒张末内径(LVDd)、每搏输出量(SV)、短轴缩短率(FS)、射血分数(EF)],血脂水平[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)],血小板活化[血小板表面细胞分化抗原40配体(CD40L)、血小板活化依赖性颗粒表面膜蛋白(CD62p)、血小板激活复合物-1(PAC-1)],T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)),微炎症状态[五聚素-3(PTX-3)、脂蛋白相关磷脂酶A2(Lp-PLA2)、血管细胞黏附分子-1(VCAM-1)]及不良反应。结果 联合组心绞痛症状疗效、心电图疗效高于单一组(P<0.05);联合组治疗后LVDd、TC、TG、LDL-C、CD40L、CD62p、PAC-1低于单一组,SV、FS、EF、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于单一组(P<0.05);联合组治疗后血清PTX-3、Lp-PLA2、VCAM-1水平低于单一组(P<0.05)。两组不良反应发生率比较无明显差异(P>0.05)。结论 辅酶Q10联合艾司洛尔治疗冠心病不稳定性心绞痛的疗效确切,可改善心功能、血脂代谢,抑制血小板活化,纠正T淋巴细胞亚群紊乱状态,缓解微炎症状态,且安全性良好。

Objective To observe the efficacy of coenzyme Q10 combined with esmolol in the treatment of unstable angina pectoris of coronary heart disease(CHD)and its effect on blood lipid level and T lymphocyte subsets.Methods A total of 116 patients with CHD unstable angina pectoris admitted to People's Hospital of Huiji District from January 2021 to January 2023 were selected as the study objects,and were divided into a single group(esmolol treatment)and a combined group(coenzyme Q10 combined esmolol treatment)according to the random even-odd allocation principle.The clinical efficacy,cardiac function[left ventricular end-diastolic diameter(LVDd),stroke output(SV),short-axis shortening rate(FS),ejection fraction(EF)],blood lipid level[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)],platelet activation[platelet surface cell differentiation antigen 40 ligand(CD40L),platelet-activated dependent granular surface membrane protein(CD62p),platelet-activated complex-1(PAC-1)],T lymphocyte subpopulation(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)),microinflammatory status[pentamylin-3(PTX-3),lipoprotein-associated phosphatidylase A2(Lp-PLA2),Vascular Cell adhesion molecule-1(VCAM-1)]and adverse reactions were observed in the two groups.Results The curative effect of angina pectoris symptom and electrocardiogram in combined group was higher than that in single group(P<0.05).After treatment,LVDd,TC,TG,LDL-C,CD40L,CD62p and PAC-1 in combined group were lower than those in single group,while SV,FS,EF,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were higher than those in single group(P<0.05).The serum PTX-3,Lp-PLA2 and VCAM-1 levels in combined group were lower than those in single group after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Coenzyme Q10 combined with esmolol is effective in the treatment of unstable angina pectoris of CHD.It can improve cardiac function,lipid metabolism,inhibit platelet activation,correct the disorder of T lymphocyte subset,relieve microinflammation,and has good safety.