CSF的影响因素及瑞舒伐他汀、尼可地尔的联合疗效研究

目的研究冠状动脉慢血流（CSF）的影响因素,以及瑞舒伐他汀和尼可地尔的联合疗效。方法选择我院2011年6月～2013年12月收治的60例CSF患者和同期收治但冠状动脉造影和血流正常的60例其他疾病患者参与研究,采用多重logistic回归分析探索CSF发病的影响因素。将CSF患者随机分为尼可地尔组和联合用药组,前者每次口服10 mg尼可地尔片,3次/d;后者在此基础上加服10 mg瑞舒伐他汀片,1次/d。治疗前和治疗3个月后,检测患者肝功能、高敏C反应蛋白（hs-CRP）浓度和肱动脉血流介导的血管扩张功能（FMD）。结果总胆固醇（TC,OR=3.10）、低密度脂蛋白-胆固醇（LDL-C,OR=4.35）、高敏C反应蛋白（hs-CRP,OR=3.25）、血管扩张功能（FMD,OR=0.59）、吸烟（OR=5.93）,合并糖尿病（OR=8.25）等均为CSF的影响因素（P〈0.05）。治疗3个月后,两组的FMD、hs-CRP及左前降支、左回旋支和右冠状动脉3个部位的血流速度都比治疗前有显著改善（P〈0.05）,且联合用药组改善幅度明显大于尼可地尔组（P〈0.05）。结论瑞舒伐他汀与尼可地尔有协同作用,可更好地改善血管内皮功能和冠状动脉血流速度,治疗CSF疗效优于单用尼可地尔。

Study on influencing factors of CSF and combined treatment efficacy of rosuvastatin and nicorandil

Objective To study the influencing factors of coronary slow flow（CSF） and combined treatment efficacy of rosuvastatin and nicorandil.Methods Total 60 CSF patients who received treatment in our hospital from Jun.of 2011 to Dec.of 2013 and other 60 patients whose coronary angiography and blood flow were normal in the same period were selected.Multi-factor logistic regression analysis was made in order to find the influencing factors inducing CSF.The CSF patients were randomly divided into nicorandil group and combined treatment group;the patients in nicorandil group took nicorandil tablet of 10 mg orally,3 times a day;while the patients in the combined treatment group took rosuvastatin tablet of 10 mg orally each day in addition to nicorandil tablet as nicorandil group.Before the treatment and 3 months after treatment,their liver function,concentration of high sensitive C reactive protein（hs-CRP）,and brachial artery flow mediated（FMD）vascular dilation function were tested.Results The total cholesterol（TC,OR =3.10）,low-density lipoprotein cholesterol（LDL-C,OR = 4.35）,hs-CRP（OR = 3.25）,flow mediated dilation（FMD,OR = 0.59）,smoking（OR = 5.93）,diabetes mellitus（OR = 8.25）were all influencing factors of CSF（P〈0.05）.After 3 months of treatment,FMD,hs-CRP,and the blood flow velocity of left anterior descending branch,left circumflex branch and right coronary artery of the two groups were significantly improved than those before the treatment（P〈0.05）;besides,the combined treatment group improved more greatly than nicorandil group（P〈0.05）.Conclusion Rosuvastatin and nicorandil are of synergistic effects;combined administration of them can better improve the endothelial function and coronary flow velocity,and the treatment efficacy for CSF is better than only use of nicorandil.