烟酸注射液联合氯吡格雷与阿司匹林治疗老年不稳定型心绞痛患者的效果

Effects of Nicotinic acid injection combined with Clopidogrel and Aspirin in treatment of elderly patients with unstable angina pectoris

目的:观察烟酸注射液联合氯吡格雷和阿司匹林治疗老年不稳定型心绞痛患者的效果。方法:选取2021-2023年该院收治的60例老年不稳定型心绞痛患者进行前瞻性研究,按照随机数字表法将其分为对照组与研究组各30例。对照组采用氯吡格雷和阿司匹林治疗,研究组在对照组基础上加用烟酸注射液治疗,比较两组临床疗效,治疗前后心功能指标[左心室舒张期末内径(LVEDD)、左心室射血分数(LVEF)、心脏室间隔厚度(IVST)、左心室收缩末期容积指数(LVESVI)、左心室舒张末期容积指数(LVEDVI)]水平、心肌损伤标志物[脑钠肽(BNP)、肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、基质金属蛋白酶-9(MMP-9)、可溶性细胞间黏附分子-1(sICAM-1)]水平、心绞痛发作情况,以及不良反应发生率。结果:研究组治疗总有效率为90.00%(27/30),高于对照组的63.33%(19/30),差异有统计学意义(P<0.05);治疗后,两组LVEDD、IVST、LVESVI、LVEDVI水平均低于治疗前,且研究组低于对照组,两组LVEF水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);治疗后,两组BNP、cTnI、CK-MB、MMP-9、sICAM-1水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组心绞痛发作持续时间均短于治疗前,且研究组短于对照组,两组心绞痛发作频率均少于治疗前,且研究组少于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:烟酸注射液联合氯吡格雷与阿司匹林治疗老年不稳定型心绞痛患者可提高治疗总有效率,改善心功能指标水平、心绞痛发作情况,以及降低心肌损伤标志物水平,效果优于氯吡格雷联合阿司匹林治疗。

Objective:To observe effects of Nicotinic acid injection combined with Clopidogrel and Aspirin in treatment of elderly patients with unstable angina pectoris.Methods:A prospective study was conducted on 60 elderly patients with unstable angina pectoris admitted to this hospital from 2021 to 2023.According to the random number table method,they were divided into control group and study group,30 cases in each group.The control group was treated with Clopidogrel and Aspirin,while the study group was treated with niacin injection on the basis of those of the control group.The clinical efficacy,the cardiac function indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),interventricular septal thickness(IVST),left ventricular end-systolic volume index(LVESVI),left ventricular end-diastolic volume index(LVEDVI)]levels,the myocardial injury markers[brain natriuretic peptide(BNP),cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB),matrix metalloproteinase-9(MMP-9),soluble intercellular adhesion molecule-1(sICAM-1)]levels,the angina pectoris attack,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of treatment in the study group was 90.00%(27/30),which was higher than 63.33%(19/30)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of LVEDD,IVST,LVESVI and LVEDVI in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;the LVEF levels of the two groups were higher than those before the treatment,and that in the study group was higher than that in the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of BNP,cTnI,CK-MB,MMP-9 and sICAM-1 in the two groups were lower than those before the treatment,those in the study group were lower than that in the control group,and the differences were statistically significant(P<0.05).After the treatment,the duration of angina pectoris in the two groups was shorter than that before the treatment,and that in the study group was shorter than that in the control group;the frequency of angina pectoris in the two groups was less than that before the treatment,and that in the study group was less than that in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Nicotinic acid injection combined with Clopidogrel and Aspirin in the treatment of the elderly patients with unstable angina pectoris can improve the total effective rate of treatment,improve the levels of cardiac function indexes and the angina pectoris,and reduce the levels of myocardial injury markers.Moreover,it is superior to Clopidogrel combined with Aspirin treatment.