非洛地平联合阿托伐他汀钙治疗老年冠心病伴心绞痛患者的临床研究

Clinical trial of felodipine combined with atorvastatin calcium in elderly patients with coronary heart disease and angina pectoris

目的观察非洛地平缓释片联合阿托伐他汀钙片对老年冠心病伴心绞痛患者心电图指标及血管内皮功能的影响。方法将老年冠心病伴心绞痛患者按照队列法分为对照组(予以阿托伐他汀钙片口服治疗,每次20 mg)和试验组(在对照组治疗的基础上,予以非洛地平缓释片联合治疗,初始剂量为5 mg,后逐渐调整至每次10 mg)。2组患者均持续治疗3个月。比较2组患者的心电图指标、血管内皮功能、血脂水平、炎性因子水平,以及药物不良反应的发生情况。结果对照组和试验组均入组60例。治疗后,试验组和对照组的QT间期离散度(QTd)分别为(37.38±4.25)和(42.05±4.74)ms,校正QT间期离散度分别为(38.53±4.66)和(43.78±4.87)ms,QRS时限值分别为(92.13±6.29)和(98.79±6.31)ms,血清一氧化氮分别为(81.31±5.68)和(77.08±4.94)μmol·L^(-1),内皮素-1分别为(51.87±3.48)和(56.19±3.53)pg·mL^(-1),白细胞介素-6分别为(9.17±1.48)和(11.42±2.13)pg·mL^(-1),血管细胞黏附分子-1分别为(120.51±12.45)和(133.76±13.64)pg·mL^(-1),C反应蛋白分别为(0.95±0.11)和(1.08±0.14)pg·mL^(-1),在统计学上差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组的总胆固醇分别为(3.65±0.47)和(3.81±0.51)mmol·L^(-1),三酰甘油分别为(1.65±0.28)和(1.71±0.33)mmol·L^(-1),低密度脂蛋白胆固醇分别为(2.34±0.31)和(2.45±0.39)mmol·L^(-1),在统计学上差异均无统计学意义(均P>0.05)。治疗期间,试验组和对照组的药物不良反应发生率分别为10.00%(6例/60例)和6.67%(4例/60例),在统计学上差异无统计学意义(P>0.05)。结论非洛地平缓释片联合阿托伐他汀钙片治疗能够有效改善老年冠心病伴心绞痛患者的心电图指标,降低炎性因子水平和血脂水平,改善血管内皮功能,具有较好的安全性。

Objective To observe the influence of felodipine sustained release tablets combined with atorvastatin calcium tablets on electrocardiogram indicators and vascular endothelial function in elderly patients with coronary heart disease(CHD)complicated with angina pectoris(AP).Methods According to cohort methods,elderly patients with CHD and AP were divided into control group(oral administration of atorvastatin calcium tablets,20 mg every time)and treatment group(combined with felodipine sustained release tablets on the basis of control group,with initial dose of 5 mg,and then gradually adjusted to 10 mg each time).The 2 groups were treated for 3 months.The electrocardiogram indicators,vascular endothelial function,blood lipids,inflammatory factors and adverse drug reactionswere compared between groups.Results Sixty cases were enrolled in each group.After 3 months of treatment,the QT interval dispersion(QTd)in treatment group and control group were(37.38±4.25)and(42.05±4.74)ms,the corrected QT interval dispersion(QTcd)values were(38.53±4.66)and(43.78±4.87)ms,the QRS duration limits were(92.13±6.29)and(98.79±6.31)ms,serum nitric oxide(NO)levels were(81.31±5.68)and(77.08±4.94)μmol·L^(-1),endothelin-1(ET-1)were(51.87±3.48)and(56.19±3.53)pg·mL^(-1),interleukin(IL)-6 levels were(9.17±1.48)and(11.42±2.13)pg·mL^(-1),vascular cell adhesion molecule(VCAM-1)levels were(120.51±12.45)and(133.76±13.64)pg·mL^(-1),C-reactive protein(CRP)levels were(0.95±0.11)and(1.08±0.14)pg·mL^(-1),respectively,with slalistically significanl dillerence(allP<0.05).After treatment,the total cholesterol levels in treatment group and control group were(3.65±0.47)and(3.81±0.51)mmol·L^(-1),triglyceride levels were(1.65±0.28)and(1.71±0.33)mmol·L^(-1),low density lipoprotein cholesterol levels were(2.34±0.31)and(2.45±0.39)mmol·L^(-1),respectively,without statistically significant diference between the 2 groups(allP>0.05).During treatment,the incidence rates of adverse reactions in treatment group and control group were 10.00%(6 cases/60 cases)and 6.67%(4 cases/60 cases)respectively,without statistically significant diference between the groups(P>0.05).Conclusion Felodipine sustained release tablets combined with atorvastatin calcium tablets can effectively improve the electrocardiogram indicators of elderly patients with CHD and AP,reduce inflammatory factors levels and blood lipids levels,and improve the vascular endothelial function,and has good safety.