银杏叶联合尼可地尔治疗老年冠心病多支病变的临床效果及对心功能的影响

Clinical effect of ginkgo biloba combined with nicorandil in the treatment of elderly coronary heart disease with multivessel lesions and its effect on cardiac function

目的观察银杏叶联合尼可地尔治疗老年冠心病多支病变的临床效果及对心功能的影响。方法按照随机抽签法将2019年5月—2020年3月南京医科大学第四附属医院及徐州医科大学附属医院泗洪分院收治的老年冠心病多支病变患者70例分为NI组(35例)与GU组(35例)。在常规治疗基础上,NI组给予尼可地尔片治疗,GU组在NI组基础上加用银杏叶片治疗,2组均治疗4周。比较2组临床疗效,治疗前后心功能指标、实验室指标[五聚蛋白3(PTX3)、可溶性CD40(sCD40)、脂蛋白相关磷脂酶A2(Lp-PLA2)],心绞痛发作次数、心绞痛持续时间、硝酸甘油用量及不良反应。结果GU组治疗总有效率为97.14%,高于NI组的77.14%(χ^(2)=4.590,P=0.032)。治疗4周后,2组左室射血分数高于治疗前,左室收缩末期内径小于治疗前,GU组升高/减小幅度大于NI组(P<0.01);2组血清PTX3、sCD40、Lp-PLA2水平低于治疗前,且GU组低于NI组(P<0.01)。GU组心绞痛持续时间短于NI组,心绞痛发作次数与硝酸甘油用量少于NI组(P<0.01)。GU组不良反应总发生率与NI组比较,差异无统计学意义(8.57%vs.11.43%,P=1.000)。结论采用银杏叶联合尼可地尔治疗老年冠心病多支病变可有效提高治疗效果,减轻患者心绞痛症状,提升心功能,保证冠状动脉粥样硬化斑块稳定,安全性较高。

Objective To observe the clinical effect of ginkgo biloba combined with nicorandil in the treatment of elderly coronary heart disease with multivessel lesions and its effect on cardiac function.Methods A total of 70 elderly patients with multivessel lesions coronary heart disease who were admitted to the Fourth Affiliated Hospital of Nanjing Medical Universit and the Sihong Branch of the Affiliated Hospital of Xuzhou Medical University from May 2019 to March 2020 were enrolled and divided into the NI group(35 cases)and the GU group(35 cases)according to the random drawing method.On the basis of conventional treatment,the NI group was treated with nicorandil tablets,and the GU group was treated with ginkgo biloba leaves on the basis of the NI group,and both groups were treated for 4 weeks.The clinical efficacy,cardiac function indexes(LVEF,LVESD),laboratory indexes(PTX3,sCD40,Lp-PLA2)before and after treatmen,the number of angina attacks,the duration of angina,the dosage of nitroglycerin and adverse reactions of the two groups were compared.Results The total effective rate of treatment in the GU group was 97.14%,which was higher than that in the NI group′s 77.14%(χ2=4.590,P=0.032).After 4 weeks of treatment,LVEF in the two groups was higher than before treatment,LVESD was lower than before treatment,and the increase/decrease in the GU group were greater than those in the NI group(P<0.01).Serum levels of PTX3,sCD40 and Lp-PLA2 in the two groups were lower than those before treatment,and those in the GU group were lower than those in the NI group(P<0.01).The duration of angina pectoris in the GU group was shorter than that in the NI group,and the number of angina attacks and nitroglycerin dosage were lower than those in the NI group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the GU group and the NI group(8.57%vs.11.43%,P=1.000).Conclusion The use of ginkgo biloba combined with nicorandil in the treatment of coronary heart disease with multivessel lesions in the elderly patients can effectively improve the treatment effect and reduce the symptoms of angina pectoris,improve cardiac function,ensure the stability of coronary atheroma plaque,and with higher safety.