尼可地尔治疗微血管性心绞痛的疗效及其对血管内皮功能的影响

目的探讨尼可地尔治疗微血管性心绞痛的临床疗效及其对血管内皮功能的影响。方法选择100例微血管性心绞痛患者，随机分为研究组和对照组各50例。对照组给予常规抗心绞痛治疗，研究组在对照组用药基础上给予尼可地尔片连续治疗3个月。治疗前后测定血浆内皮索（ET-1）、一氧化氮（NO）及血清高敏C反应蛋白（hs-CRP）水平。结果研究组症状疗效总有效率为94．0％，对照组为76．0％，差异有统计学意义（P〈0．05）。研究组心电图疗效总有效率为90．0％，对照组为72．0％，差异有统计学意义（P〈0．05）。研究组治疗后与治疗前比较NO水平显著升高，ET-1及CRP水平显著减低，差异均有统计学意义（P〈0．01）。结论尼可地尔通过抑制炎症因子、改善血管内皮功能机制改善微血管性心绞痛症状，且疗效显著。

Clinical efficacy of nicorandil in the treatment of microvascular angina and its effect on vascular endothelial function.

Objective To investigate the efficacy of nicorandil in the treatment of microvascular angina and its effect on vascular endothelial function. Methods One hundred patients with microvascular angina were randomly divided into the study group and the control group, with 50 cases in each group. The control group underwent conventional anti-anginal therapy, on the basis of which the study group underwent additional nicorandil tablets for three-month continuous treatment. The plasma levels of endothelin （ET-1） and nitric oxide （NO）, and serum levels of high-sensitivity C-reactive protein （hs-CRP） were measured before and after treatment respectively. Results The total effective rate of symptoms was 94.0 % in the study group and 76.0% in the control group, with statistically signifi- cant difference between the two groups （P〈0.05）. The total effective rate of curative effects on ECG was 90.0% in the study group and 72.0% in the control group, with statistically significant difference （P〈0.05）. In the study group, the NO levels after treatment were significantly increased compared with those before treatment, while ET-1 and CRP levels were significantly reduced, with statistically significant difference （P〈0.01）. Conclusion Nicorandil could inhibit the inflammatory cytokines and improve the endothelial function, so as to improve microvascular angina symptoms, with a significant curative effect.