Analysis of the Nursing Effect of Continuity of Care on Elderly Patients with Coronary Heart Disease Unstable Angina and its Impact on Quality of Life

Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.

Effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following cardiac stent implantation

BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion,promoting blood flow restoration and alleviating symptoms such as myocardial ischemia.And postoperative cardiac rehabilitation is essential for enhancing recovery and prognosis.Nevertheless,conventional rehabilitation lacks specificity,particularly for elderly patients with multiple comorbidities and poor compliance,rendering it less effective.AIM To investigate the effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following coronary stenting intervention.METHODS A retrospective enrollment was conducted comprising fifty-four elderly patients with unstable angina pectoris who underwent systematic cardiac rehabilitation training after receiving coronary intervention as the rehabilitation group,while fifty-three elderly patients who received basic nursing and rehabilitation guidance measures after coronary intervention were assigned to the control group.Differences in Seattle Angina Questionnaire scores,survival quality(SF-36)scores,cardiopulmonary exercise function assessment index,echocardiographic cardiac function index,and adverse cardiovascular events were compared between the two groups.RESULTS After intervention,the rehabilitation group observed greater VO2 Max,maximum metabolic equivalent,eft ventricular ejection fraction,left ventricular end-diastolic diameter and smaller left ventricular end-systolic diameter.And the rehabilitation group observed greater scores of physical activity limitation,stable angina pectoris,treatment satisfaction,and SF-36 score.The incidence of adverse cardiovascular events in the two groups,showed no significant difference.CONCLUSION Systematic cardiac rehabilitation following coronary stenting in elderly patients with unstable angina pectoris can enhance cardiac function recovery,consequently enhancing both quality of life and cardiopulmonary exercise tolerance.

Vasospastic angina in women: Clinical backgrounds and prognoses of patients younger than and older than 60 years

BACKGROUND We frequently encounter cases of women with vasospastic angina(VSA).Additionally,some women with VSA are younger than 60 years old.However,it is unknown whether the characteristics of VSA in women aged<60 years are different from those in women aged≥60 years.AIM To investigate and compare the clinical characteristics and prognosis of VSA in women aged<60 years from those in women aged≥60 years.METHODS We enrolled 94 women with VSA who were diagnosed using the spasm provocation test.According to the age at diagnosis,the patients were divided into two groups:Group Y(age<60 years,n=17)and Group O(age≥60 years,n=77).Flow-mediated dilation(FMD)and nitroglycerin(NTG)-induced dilation(NID)of the brachial artery were performed and assessed using brachial ultrasonography.Moreover,conventional coronary risk factors,such as atherosclerotic lesions(stenosis>20%)detected using coronary angiography and focal spasms(coronary spasm within one segment of one coronary artery),and major cardiovascular adverse events(MACE)were assessed in both groups.RESULTS Smoking was more prevalent in Group Y than in Group O(P=0.04).FMD was similar in both groups(Group O:4.3%±3.2%,Group Y:4.5%±3.3%;P=0.75),whereas NID was higher in Group Y(20.5%±8.6%)than in Group O(13.6%±5.3%,P<0.01).Atherosclerosis was not detected in Group Y but was detected in Group O(61%,P<0.01).Focal spasms were less frequent in Group Y(12%)than in Group O(38%,P=0.04).The incidence of major adverse cardiac events did not differ between the two groups(P=0.40).CONCLUSIONWomen aged < 60 years with VSA have less atherosclerotic lesions and focal spasms. These characteristicsmay be affected by smoking habits and vascular smooth muscle dysfunction.

Efficacy and prognostic impact of Pericarpium Trichosanthis injection combined with nicorandil for intractable angina pectoris in elderly patients: A retrospective study

BACKGROUND Coronary artery disease(CAD)is a leading cause of global cardiovascular morta-lity.Refractory angina pectoris,a manifestation of CAD,requires effective drug treatments.Pericarpium Trichosanthis injection,a traditional Chinese medicine,improves cardiovascular symptoms,while nicorandil alleviates spasms and angina.Both have potential in treating CAD.AIM To investigate the therapeutic effects of combining Pericarpium Trichosanthis injection and nicorandil in elderly patients suffering from refractory angina caused by coronary heart disease.METHODS A retrospective analysis was conducted on the data of 130 patients diagnosed with refractory coronary heart disease.Based on the different treatment regimens administered during hospitalization,the patients were divided into a control group(58 cases)and a study group(72 cases).The control group received conven-tional treatment,which included aspirin,statins,and nitrate vasodilators.In addition to the conventional medication,the study group received a combination treatment of Pericarpium Trichosanthis injection and nicorandil.RESULTS After treatment,the study group showed significantly higher left ventricular ejection fraction and cardiac output,and lower brain natriuretic peptide and C-reactive protein levels compared to the control group.The study group also exhibited improvements in angina,quality of life,exercise endurance,and lipid profiles.Multivariate logistic regression analysis revealed a relationship of lipid levels and heart function with the combined treatment.Some patients in the study group experienced headaches during treatment,but no significant adverse reactions were observed.Follow-up showed that the treatment was well-tolerated,with no drug-related adverse reactions detected.CONCLUSION Combination of Pericarpium Trichosanthis injection and nicorandil is more effective than conventional treatment in improving symptoms and heart function in elderly patients with refractory angina pectoris.

Advances in Research of Treatment of Angina Pectoris in Coronary Heart Disease from the Method of Dredging Collaterals with Pungent

The angina pectoris in coronary heart disease belongs to the category of"chest impediment"in traditional Chinese medicine,and belongs to the syndrome of root deficiency with tip excess.Its main pathogenesis is obstruction of the heart collaterals,and treatment mainly adopts dredging collaterals and relieving pain.Based on the treatment principles of dredging collaterals with pungent,aiming at the etiology,pathogenesis and disease characteristics of angina pectoris in coronary heart disease,this article systematically analyzes the Method of Dredging Collaterals with Pungent including the methods of dredging collaterals with pungent moisture,dredging collaterals with pungent warm,dredging collaterals with pungent aroma,and dredging collaterals with insect type drugs,to provide ideas for the treatment of angina pectoris in coronary heart disease.

食道异物诱发Ludwig’s angina继发Ⅱ度喉梗阻1例

路德维希咽峡炎(Ludwig’s angina,LA)又称为坏死性颈筋膜炎,是口底、颌下和颈部的一种弥漫性坏死性感染,病情凶险、发展迅速,常并发脓毒症、肺炎、窒息、脓胸及心包炎,当LA累及颌下和舌下间隙时,由于靠近咽喉及气道,感染从舌下间隙扩散到会厌易引起气道阻塞,误诊和延误治疗常常导致患者死亡[1,2]。有研究发现,通过及时的气道管理、抗生素治疗、先进的成像技术以及外科手术治疗,LA目前的病死率降至8%,而入住ICU的LA患者,病死率仍为10.34%[3,4]。牙源性感染、扁桃体周围脓肿、腮腺炎、中耳炎或头颈部手术为LA发生的常见原因,其中牙源性感染是主要原因[5],食道异物后继发LA极为罕见,国内外文献均未见报导。糖尿病不仅是该病的主要危险因素之一,合并糖尿病还会增加患者死亡率。我院于2019年收治1例因食道异物后出现LA,后继发喉梗阻Ⅱ°合并糖尿病的患者,经过38d的治疗与观察,患者病情平稳后出院。

A systematic review and meta-analysis of Dengzhanxixin injection for coronary heart disease with angina pectoris patients

Background:Dengzhanxixin Injection(DZXXI)has been widely used to treat Coronary heart disease with angina pectoris patients.Therefore,the study aimed to evaluate the therapeutic efficacy and safety of DZXXI in treating Coronary heart disease with angina pectoris.Methods:The Cochrane Library,the China National Knowledge Infrastructure database,the Wanfang database,the VIP database,the PubMed database,the Medline database,the EMBASE database,and Clinical Trial were used to search literatures up to August 2022.Results:The results showed that DZXXI combined with conventional therapy were significant in clinical efficacy(relative risk(RR)=1.23,95%cerebral infarction(CI):1.18,1.29;P<0.01)and electrocardiogram curative effect(RR=1.35,95%CI:1.24-1.47;P<0.01),even the subgroup of the DZXXI≤20 ml showed the largest difference.In addition,DZXXI combined with conventional therapy could lower the level of triacylglycerol(mean difference(MD)=−0.63,95%CI:−0.72,−0.55;P<0.01),total cholesterol(MD=−1.18,95%CI:−1.28,−1.09;P<0.01)and low density lipoprotein-cholesterol(MD=−0.98,95%CI:−1.08,−0.88;P<0.01),improve the level of high density lipoprotein-cholesterol(MD=0.41,95%CI:0.33,0.49;P<0.01),blood viscosity(MD=−1.09,95%CI:−1.32,−1.86,P<0.01),plasma viscosity(MD=−0.11,95%CI:−0.11,−0.11,P<0.01)and fibrin(MD=−1.50,95%CI:−1.53,−1.47,P<0.01).Conclusion:These findings revealed that there was more efficacious in DZXXI combined with conventional therapy than that in conventional therapy for the Coronary heart disease with angina pectoris and low dose of DZXXI might be suggested.

阿利沙坦酯联合硝苯地平缓释片对中重度原发性高血压伴心绞痛疗效和安全性的研究

目的观察阿利沙坦酯联合硝苯地平缓释片对中重度原发性高血压伴心绞痛疗效和安全性。方法选取2021年1月至2022年1月佛山市中医院禅城高新区医院老年医学科收治的符合纳入标准的120例中重度原发性高血压伴心绞痛患者,根据随机数表法分为研究组和对照组,每组各60例。对照组使用硝苯地平缓释片Ⅰ治疗,研究组在对照组基础上联合阿利沙坦酯片治疗,疗程为12周。治疗前后测量诊室血压并进行动态血压监测,评估降压效果,计算血压达标率。记录治疗期间两组心绞痛发作持续时间、发作频率、硝酸甘油用量,评估心绞痛改善情况。测量治疗前后患者生命体征,并行血尿常规、血糖、胆固醇、三酰甘油、尿素氮、肌酐、尿酸、血电解质、转氨酶、血清肌酐等实验室检查,记录治疗期间不良反应发生情况。结果治疗后,两组诊室收缩压(SBP)和舒张压(DBP)均较治疗前降低,且研究组低于对照组(P<0.05)。治疗后,两组24 h SBP、24 h DBP、白昼SBP(dSBP)、白昼DBP(dDBP)、夜间SBP(nSBP)和夜间DBP(nDBP)均降低,且研究组低于对照组(P<0.05)。研究组降压总有效率高于对照组(P<0.05)。两组与同组治疗2周后和治疗4周后比较,治疗8周后和治疗12周后两组血压达标率均增加(P<0.05)。治疗后,两组心绞痛发作持续时间、发作频率、硝酸甘油用量均较治疗前减少,且研究组低于对照组(P<0.05)。研究组心绞痛改善总有效率高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论阿利沙坦酯联合硝苯地平缓释片治疗中重度原发性高血压伴心绞痛疗效显著,有效降压并维持血压稳定的同时,还可改善心绞痛症状,且安全性较高,具有临床应用价值。

谷红注射液治疗不稳定性心绞痛的临床疗效和安全性研究

目的 观察谷红注射液治疗不稳定性心绞痛患者的临床疗效和安全性。方法 本研究为一项多中心前瞻性研究,采用随机、双盲、平行对照的临床试验设计方法,纳入2021年08月05日至2024年04月16日就诊于20家医院的不稳定性心绞痛患者608例,随机分为试验组和对照组各304例。试验组给予谷红注射液,对照组给予安慰剂(0.9%Nacl溶液),两组疗程均为10 d。比较两组临床疗效、心绞痛发作次数和西雅图心绞痛量表(SAQ)评分,观察并记录治疗期间的不良反应。结果 治疗10 d后,试验组的心绞痛有效率优于对照组(93.62%比81.76%,P<0.001);2组心绞痛发作次数均较治疗前减少(P<0.05),其中以试验组的心绞痛发作次数减少更为明显(P<0.05);治疗28 d后,两组SAQ评分均有所升高,试验组SAQ评分较基线增加更多,差异有统计学意义(P<0.05)。两组的不良反应发生率差异无统计学意义(P>0.05)。综合不良反应、临床实验室检查、心电图和生命体征等安全性评价指标结果显示,两组的安全性相当。结论 谷红注射液具有疗效确切、安全可靠的优点,且能够提高临床顺应性,可有效改善不稳定性心绞痛患者的临床症状,提高生活质量,值得临床推广使用。

中老年冠心病心绞痛患者中医虚证诊断模型的探索与构建

目的 构建中老年冠心病心绞痛中医虚证的诊断预测模型。方法 选取2021年1月至2022年12月南京中医药大学泰州附属医院住院的160例冠心病心绞痛中老年(50~85岁)患者的临床资料,统计年龄、性别、体重指数、吸烟、饮酒、血常规、血脂、肝肾功能、冠状动脉血管病变程度,以及高血压病、糖尿病、胃肠道疾病、慢性阻塞性肺疾病、脑血管疾病等合并症作为自变量,每位患者均给出虚实辨证,其结果作为因变量。应用单因素logistic回归筛选变量,多因素logistic回归分析建立模型,可视化模型。使用受试者操作特征曲线、校准曲线及决策曲线分析评估模型。结果 160例患者实证83例,虚证77例。多因素回归结果显示:年龄>67~85岁[OR=2.776,95%CI(1.219,6.321),P=0.015]、糖尿病[OR=2.230,95%CI(0.960,5.178),P=0.062]、Genisi评分4.50~7.50[OR=10.126,95%CI(2.574,39.843),P=0.001]、Genisi评分8.00~15.75 [OR=13.510,95%CI(3.441,53.040),P<0.001]、Genisi评分16.00~80.00[OR=53.032,95%CI(11.769,230.027),P<0.001]是冠心病心绞痛虚证的预测因子。模型方程为:Logit(虚证概率)=-4.231+1.021×年龄(>67~85岁)+0.802×患糖尿病+2.315×Gensini等级(4.50~7.50)+2.603×Gensini等级(8.00~15.75)+3.952×Gensini等级(16.00~80.00)。该模型受试者曲线下面积值为0.852(95%CI:0.795~0.910)。校准度曲线提示准确度较好,决策曲线分析表现在该预测变量在6%~85%广大风险范围内展现出较好的正向收益率。结论 本研究构建了一个中老年冠心病心绞痛虚证诊断预测模型,有较好的临床预测能力。

川芎挥发油治疗心绞痛的网络药理学研究及实验验证

目的 基于网络药理学研究川芎挥发油抗心绞痛的作用机制,并用动物实验加以验证。方法 通过水蒸气蒸馏法、气相色谱-质谱联用仪(gas chromatography-mass spectrometry, GC-MS)、口服利用度(oral bioavailability, OB)筛出挥发油成分;使用Pubchem、SwissTarget、DisGeNET、DrugBank数据库和R语言分别获取挥发油成分的靶点、心绞痛的靶点和交集靶点;蛋白质-蛋白质相互作用通过String数据库完成;使用R语言的ClusterProfiler包对交集靶点进行基因本体分析(gene ontology, GO)和京都基因与基因组百科全书分析(Kyoto Encyclopedia of Genes and Genomes, KEGG)富集分析,并通过Cytoscape构建中药-成分-靶点-通路网络;借助AutoDock vina 1.2.3、Pymol 3.0、Discovery Studio 2016软件进行分子对接,分析关键靶点和主要挥发油成分的亲和力。最后,通过动物实验进一步验证川芎挥发油对心绞痛的治疗效果。结果 网络药理学研究共得到10个挥发油成分和22个关键靶点,这些靶点与神经递质、突触膜上的受体、物质代谢等生物过程以及神经活性配体-受体相互作用、视黄醇代谢、药物代谢-细胞色素P450等通路密切相关;分子对接结果表明3-butylidenephthalide、Alpha-selinene、Trans-ligustilide等挥发油成分与多个关键靶点结合发挥治疗作用。动物实验表明川芎挥发油通过调节射血分数(ejection fraction, EF)、短轴缩短率(fractional shortening, FS)、左室收缩末内径(left ventricular internal diameter in systole, LVIDs)和每搏输出量(stroke volume, SV)水平以及乳酸脱氢酶(lactate dehydrogenase, LDH)、肌酸激酶(creatine kinase, CK)、天冬氨酸转氨酶(aspartate aminotransferase, AST)活性,促进受损心肌细胞中ADRA1A、CHRM5蛋白的表达,改善心肌纤维状态,减小细胞间隙,减少炎性细胞浸润表现出保护心肌的作用。结论 川芎挥发油具有有效保护受损心肌组织,治疗心绞痛的作用。

益气活血汤治疗不稳定型心绞痛老年患者的疗效及对其血流动力学和心电图的影响

目的探究益气活血汤对不稳定型心绞痛(Unstable angina pectoris,UAP)老年患者的疗效及对其血流动力学和心电图的影响。方法选取2019年5月-2022年6月期间大连市友谊医院老年医学中心老年病科收治的92例UAP老年患者,按随机数字表法分为对照组和观察组,每组各46例。对照组给予常规治疗,观察组在对照组基础上给予益气活血汤治疗,均持续治疗4周。观察比较两组患者临床疗效、心电图改善情况,治疗前后血脂[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)]水平、血流动力学(全血还原黏度、纤维蛋白原、红细胞聚集指数、血浆黏度)指标及不良反应发生情况。结果治疗后观察组临床总有效率91.30%(42/46)明显高于对照组73.91%(34/46),差异有统计学意义(P<0.05)。治疗后两组患者血脂TC、TG、LDL-C水平均较治疗前降低,HDL-C水平较治疗前升高,差异有统计学意义(P<0.05);且观察组TC、TG、LDL-C水平均明显低于对照组,HDL-C水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者全血还原黏度、红细胞聚集指数、纤维蛋白原、血浆黏度均较治疗前降低,差异有统计学意义(P<0.05);且观察组血流动力学指标明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组心电图改善总有效率86.96%(40/46)明显高于对照组67.39%(31/46),差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论益气活血汤治疗老年UAP的疗效显著,可有效改善患者血流动力学指标和心电图情况。

疏肝温胆汤对不稳定型心绞痛中医证候疗效、动态心电图、血脂水平和炎症因子水平的影响

目的:分析疏肝温胆汤对不稳定型心绞痛中医证候疗效、动态心电图、血脂水平和炎症因子水平的影响。方法:2022年5月~2023年5月我院收治的121例不稳定型心绞痛患者,采用随机数字表法分为观察组和对照组,其中58例对照组患者采取低脂低盐饮食、适当运动和对症药物治疗等常规治疗,另63例在对照组基础上接受疏肝温胆汤治疗,均治疗3个月。检查和检测动态心电图、血脂水平,采用酶联免疫吸附法检测血清中炎性因子水平。结果:治疗3个月后,观察组中医证候疗效为95.24%,高于对照组的82.76%(P<0.05);观察组正常R-R间期的平均值标准差(SDNN)、正常相邻心跳差值>50ms与总心跳次数数的百分比(pNN50)、24h频域功率、最大频域功率小时、最小频域功率小时分别为(125.23±31.47)ms、(10.84±2.79)%、(2490.37±538.80)ms^(2)/Hz、(886.14±227.51)ms^(2)/Hz和(5783.25±514.97)ms^(2)/Hz,均高于对照组[(113.73±28.96)ms、(8.06±2.53)%、(2236.17±486.31)ms^(2)/Hz、(772.39±213.52)ms^(2)/Hz和(5026.11±493.25)ms^(2)/Hz,P<0.05];观察组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平分别为(3.89±0.86)mmol/L、(1.74±0.42)mmol/L和(2.13±0.36)mmol/L低于对照组[(4.35±0.81)mmol/L、(2.35±0.56)mmol/L和(2.55±0.40)mmol/L],观察组高密度脂蛋白胆固醇(HDL-C)水平为(2.41±0.39)mmol/L,高于对照组[(1.92±0.41)mmol/L,P<0.05];观察组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、脂蛋白相关的磷脂酶A2(Lp-PLA2)水平分别为(8.13±1.54)ng/L、(4.18±1.15)ng/L、(1.44±0.27)mg/L和(155.37±36.31)ng/L均低于对照组[(10.29±1.97)ng/L、(6.42±1.38)ng/L、(1.89±0.31)mg/L和(187.59±32.46)ng/L,P<0.05]。结论:应用疏肝温胆汤可有效提升不稳定型心绞痛患者中医证候疗效,改善心功能,降低血脂和炎症水平,进而改善脂质代谢和体内微环境。

瑞舒伐他汀联合氯吡格雷治疗冠心病不稳定型心绞痛的有效性探讨

目的探讨对于冠状动脉粥样硬化性心脏病(简称冠心病)不稳定心绞痛患者实施瑞舒伐他汀联合氯吡格雷治疗的有效性及安全性。方法选取2021年3月—2022年12月东台市中医院收治的116例冠心病不稳定心绞痛患者为研究对象,均实施常规药物(如阿司匹林肠溶片+酒石酸美托洛尔+低分子肝素)治疗,以随机摸球法将其分为两组,各58例。对照组在常规处理后联合辛伐他汀,治疗组在常规处理后给予瑞舒伐他汀联合氯吡格雷治疗。对比两组治疗有效性、心绞痛发作情况、血脂指标和安全性。结果治疗组治疗总有效率(96.55%)高于对照组(86.21%),差异有统计学意义(χ^(2)=3.940,P<0.05)。经过6周治疗后,治疗组心绞痛发作频率及持续时间均少于对照组,差异有统计学意义(P均<0.05);治疗组血脂指标中三酰甘油、总胆固醇及低密度脂蛋白胆固醇水平明显低于对照组低,高密度脂蛋白胆固醇水平显著高于对照组,差异有统计学意义(P均<0.05)。治疗组不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论对冠心病不稳定型心绞痛患者以瑞舒伐他汀联合氯吡格雷进行治疗,能减少心绞痛发作情况,缩短发作持续时间,控制血脂水平,同时也具有一定的安全性,可减少不良反应。

不稳定型心绞痛患者血清RBP-4、Lp-PLA2水平及依折麦布治疗影响研究

目的探究不稳定型心绞痛(UA)患者血清视黄醇结合蛋白-4(RBP-4)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平及依折麦布治疗影响。方法选取2021年1月至2023年1月于唐山市人民医院心内科确诊的UA患者84例为研究对象,其中男性48例,女性36例;根据冠状动脉病变程度分为:Gensini评分<20分为轻度组(27例)、20分≤Gensini评分<40分为中度组(36例)和Gensini评分≥40分为重度组(21例);按随机数字表法分为观察组和对照组,每组各42例。所有患者均行常规治疗,对照组在此基础上给予瑞舒伐他汀治疗,观察组给予瑞舒伐他汀+依折麦布治疗,两组患者均连续治疗6个月。比较不同冠状动脉病变程度组RBP-4、Lp-PLA2水平;比较治疗后观察组和对照组脂代谢、RBP-4、Lp-PLA2水平以及不良心血管事件的发生情况。结果①血清RBP-4、Lp-PLA2水平为:轻度组<中度组<重度组,差异有统计学意义(P<0.05)。斯皮尔曼等级相关分析显示,血清RBP-4、Lp-PLA2水平与UA患者冠状动脉病变程度呈正相关(r=0.844、r=0.729,P<0.05)。②重复测量方差分析显示,血脂水平时点、组间、交互比较差异有统计学意义(P<0.05)。治疗前,两组总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)水平的比较,差异无统计学意义(P>0.05);治疗3个月、6个月,两组TC、TG、LDL-C的水平均降低(P<0.05),而HDL-C升高(P<0.05),且观察组TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.05)。③重复测量方差分析显示,RBP-4、Lp-PLA2水平时点、组间、交互比较,差异有统计学意义(P<0.05)。治疗前,两组RBP-4、Lp-PLA2水平比较,差异无统计学意义(P>0.05);治疗3个月、6个月,两组RBP-4、Lp-PLA2水平均降低(P<0.05),且观察组RBP-4、Lp-PLA2水平低于对照组,差异有统计学意义(P<0.05)。④观察组心血管事件发生率(7.14%)低于对照组(23.81%),差异有统计学意义(P<0.05)。结论UA患者血清RBP-4、Lp-PLA2水平与冠状动脉病变程度相关,依折麦布可改善不稳定型心绞痛患者的脂代谢水平,调节血清RBP-4、Lp-PLA2水平,减少心血管事件发生。

夏橘化瘀胶囊治疗气虚血瘀型冠状动脉旁路移植术后再发心绞痛的临床效果

目的 探讨夏橘化瘀胶囊治疗气虚血瘀型冠状动脉旁路移植术后再发心绞痛的临床效果。方法 选取2021年1月至12月山东省潍坊市中医院收治的70例行冠状动脉旁路移植术后再发心绞痛患者为研究对象,采用随机数字表法将其分为对照组和观察组,各35例。对照组采用西医常规治疗,观察组采用西医常规治疗+夏橘化瘀胶囊,两组均连续治疗3个月。比较两组中医证候疗效,比较两组治疗前后心绞痛发病频率、持续时间、西雅图心绞痛量表评分、N-末端B型利钠肽前体(NT-pro BNP)、超敏C反应蛋白(hs-CRP)水平,同时记录患者相关安全性指标。结果 观察组中医证候疗效优于对照组(P<0.05)。治疗后,两组心绞痛发病频率少于治疗前、持续时间短于治疗前,且观察组心绞痛发病频率少于对照组、持续时间短于对照组(P<0.05)。治疗后,两组西雅图心绞痛量表各项评分均高于治疗前,且观察组高于对照组(P<0.05)。治疗后,两组血清NT-pro BNP、hs-CRP水平低于治疗前,且观察组低于对照组(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 夏橘化瘀胶囊对冠状动脉旁路移植术后再发心绞痛有明显改善作用,且安全性较高,具有重要的临床应用价值。

艾灸联合曲美他嗪对老年冠心病稳定型心绞痛患者血小板聚集功能的影响

目的 探讨艾灸联合曲美他嗪用于老年冠心病稳定型心绞痛的效果,观察血小板聚集功能变化。方法 选取2020年1月至2022年1月收治的冠心病稳定型心绞痛患者96例,随机数字表法分为观察组和对照组,每组48例。对照组给予曲美他嗪治疗,观察组在对照组基础上加用艾灸治疗。观察2组患者临床疗效,比较2组患者治疗前后中医证候评分、心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、血小板聚集功能、心绞痛发作次数、持续时间及西雅图心绞痛量表(SAQ)评分,观察不良反应发生情况。结果 观察组临床总有效率显著高于对照组(P<0.05);观察组胸痛胸闷、面色暗紫、痰多体胖、倦态乏力评分均低于治疗前且低于对照组治疗后(P<0.05);治疗后观察组2.5μmol/L、5μmol/L、300μmol/L诱导剂下的血小板聚集均显著低于治疗前且低于对照组治疗后(P<0.05);观察组LVEF、SAQ量表高于治疗前及对照组,LVEDD、LVESD、心绞痛发作次数、持续时间低于治疗前及对照组(P<0.05);2组患者不良反应差异无统计学意义(P>0.05)。结论 艾灸联合曲美他嗪可改善老年冠心病稳定型心绞痛患者心功能、血小板聚集功能,减少患者心绞痛频率及持续时间,安全性高。

我国心系疾病中医护理研究的CiteSpace知识图谱可视化分析

目的:使用文献计量学方法分析我国心系疾病中医护理研究现状及热点。方法:检索中国知网、万方数据库、中国生物医学文献数据库、维普数据库中的心系疾病中医护理相关研究,对纳入的文献进行可视化分析。结果:心系疾病中医护理研究文献量总体呈上升趋势,但作者及各研究机构间的合作不足,研究症状主要有便秘、焦虑、抑郁和失眠等,心系疾病中医护理研究领域更加关注老年群体,提倡辨证施护、舒适护理,以提高病人生活质量为目标。结论:心系疾病中医护理相关研究文献量较少,作者与研究机构间的合作有待加强,需优化心系疾病中医护理方案,为临床护士开展辨证施护、实施适宜的中医护理技术提供参考,推动中医护理长期、稳定地发展。

麝香保心丸对微血管心绞痛血管内皮功能的影响

目的测定原发性微血管心绞痛(primarymicrovascular angina,PMVA)患者血浆血管性假血友病因子(von Willebrand factor,v WF)水平评价血管内皮功能,观察给予麝香保心丸治疗前后v WF水平的改变。方法明确诊断PMVA的患者69例,采用随机数字表法分为常规治疗组33例和麝香保心丸组36例,比较两组患者治疗前后vWF水平。结果常规治疗组治疗前vWF(50.93±32.98)μg/L治疗后v WF(49.65±35.12)μg/L,麝香保心丸组治疗前v WF(27.45±25.02)μg/L治疗后v WF(17.37±15.68)μg/L。治疗后vWF下降值麝香保心丸组(10.08±16.47)μg/L较常规治疗组(1.28±12.37)μg/L更明显,P<0.05。结论麝香保心丸具有血管内皮保护功能,PMVA患者能从治疗中获益。

不稳定心绞痛老年住院患者经皮冠状动脉介入术后生活质量影响因素研究

目的分析影响不稳定心绞痛(Unstable Angina,UA)老年住院患者经皮冠状动脉介入术(Percutaneous Coronary Intervention,PCI)后生活质量的影响因素。方法采用方便抽样方法选取部分UA老年住院患者进行调查。采用多元线性回归模型分析影响UA老年住院患者PCI术后生活质量的主要因素,采用方差分析、Pearson相关分析法分析其生活质量得分与健康素养各项得分间的关系。结果UA老年住院患者PCI术后生活质量平均得分为(103.76±14.38)分。多元线性回归分析结果显示,年龄>79岁(β=5.829)、初中及以下文化程度(β=5.264)、家庭人均月收入<3000元(β=4.064)、非医保付费方式(β=7.103)、无运动训练(β=6.182)、未规律服药(β=8.176)是影响UA老年住院患者PCI术后生活质量的主要因素(P<0.05)。方差分析结果显示,UA老年住院患者的信息获取能力、交流互动能力、改善健康意愿、经济支持意愿得分均随其生活质量评分降低而降低(P<0.05)。Pearson相关分析结果显示,UA老年住院患者信息获取能力、交流互动能力、改善健康意愿、经济支持意愿各维度得分均与其生活质量评分呈正相关(P<0.05)。结论影响UA老年住院患者PCI术后生活质量的因素较多,且生活质量与其健康素养各项得分均呈正相关。