尼可地尔联合瑞舒伐他汀钙治疗冠状动脉慢血流患者的效果观察

Effect of nicorandil combined with rosuvastatin calcium in treatment of patients with slow coronary flow

目的探讨尼可地尔联合瑞舒伐他汀钙对冠状动脉慢血流(CSF)患者单核细胞与高密度脂蛋白胆固醇比值(MHR)、系统免疫炎症指数(SII)和心功能等的影响。方法采用成组病例对照研究方法,选取240例经冠状动脉造影检查证实CSF患者作为研究对象,随机分为观察组和对照组,每组120例。在常规药物治疗基础上,对照组采用瑞舒伐他汀钙治疗,观察组采用尼可地尔联合瑞舒伐他汀钙治疗,2组均治疗6个月。比较2组患者的临床疗效、炎症指标[超敏C反应蛋白(hs-CRP)、MHR、SII]水平、冠状动脉主要分支[左前降支(LAD)、左回旋支(LCX)、右冠状动脉(RCA)]的校正TIMI帧数(CTFC)、心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室整体纵向应变(GLS)]和主要不良心血管事件(MACE)发生情况。结果观察组总有效率为95.00%,高于对照组的80.00%,差异有统计学意义(P<0.05)。治疗后,2组心绞痛发作持续时间缩短、疼痛程度减轻、发作次数减少,且观察组变化程度大于对照组,差异有统计学意义(P<0.05)。治疗6个月后,2组血清hs-CRP、MHR、SII均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗6个月后,2组LAD、LCX、RCA的CTFC均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗6个月后,2组LVEF、GLS绝对值均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05),但2组LVEDD差异无统计学意义(P>0.05)。2组MACE发生情况比较,差异无统计学意义(P>0.05)。结论将尼可地尔联合瑞舒伐他汀钙应用于CSF患者的治疗中,能显著提升治疗总有效率,降低hs-CRP、MHR、SII水平,改善LVEF、LVEDD、GLS等心功能指标,并有效减轻心绞痛发作程度。

Objective To investigate the effects of nicorandil combined with rosuvastatin calcium on monocyte-to-high density lipoprotein cholesterol ratio(MHR),systemic immune-inflammation index(SII),and cardiac function in patients with coronary slow flow(CSF).Methods A group case-control study was used to select 240 patients with CSF confirmed by coronary angiography,and they were randomly divided into observation group and control group,with 120 patients in each group.On the basis of conventional drug treatment,the control group was treated with rosuvastatin calcium,while the observation group was treated with nicorandil combined with rosuvastatin calcium for 6 months.Clinical efficacy,inflammatory markers[high-sensitivity C-reactive protein(hs-CRP),MHR,SII],corrected TIMI frame count(CTFC)of major coronary branches[left anterior descending branch(LAD),left circumflex branch(LCX),right coronary artery(RCA)],cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),global longitudinal strain(GLS)],and the occurrence of major adverse cardiovascular events(MACE)were compared between the two groups.Results The total effective rate in the observation groupwas significantly higher than that in the control group(95.00%versus 80.00%,P<0.05).After treatment,the duration,severity,andfrequency of angina pectoris attacks were reduced or shortened in both groups,with more changes observed in the observation group(P<0.05).Serum levels of hs-CRP,MHR,and SII were lower in both groups after 6 months of treatment,and the observation group with significantly was lower compared to the control group(P<0.05).CTFC values of LAD,LCX,and RCA were also lower in both groups after 6 months,with the observation group showing significantly lower values(P<0.05).The absolute values of LVEF and GLS increased in both groups after 6 months of treatment,and the observation group was higher than the control group(P<0.05).However,no significant difference was observed in LVEDD and occurrence of MACE between the two groups(P>0.05).Conclusion The application of nicorandil combined with rosuvastatin calcium in the treatment of CSF patients can significantly improve the overall treatment efficacy,reduce hs-CRP,MHR,and SII levels,enhance cardiac function indicators such as LVEF,LVEDD,and GLS,and effectively alleviate the severity of angina pectoris attacks.