硝苯地平联合依那普利对老年冠心病伴高血压患者血脂代谢血管内皮功能及炎症反应的影响

doi:10.3969/j.issn.1006-6233.2023.05.033

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摘要 目的:观察硝苯地平联合依那普利对老年冠心病伴高血压患者血管内皮功能、血脂代谢及炎症反应的影响。方法:选取河西学院附属张掖人民医院2020年01月至2021年07月收治的168例老年冠心病伴高血压患者为对象,采用奇偶数随机法分为两组。对照组82例给予硝苯地平治疗,联合组86例在对照组基础上联合依那普利治疗。比较两组血脂代谢、血管内皮功能、炎症反应相关指标的差异,评价两组疗效和安全性。结果:两组治疗前血脂代谢、血管内皮功能、炎症反应相关指标比较,差异无统计学意义(P>0.05);与治疗前相比,两组高密度脂蛋白胆固醇(HDL-C)、一氧化氮(NO)、载脂蛋白-A1(Apo-A1)、C1q肿瘤坏死因子相关蛋白3(CTRP3)、载脂蛋白-B(Apo-B)治疗后升高,且联合组升高更明显(P<0.05);两组总胆固醇(TC)、内皮素(ET)、可溶性血管黏附因子-1(sVCAM-1)、甘油三酯(TG)、高敏-C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(a)[LP(a)]治疗后下降,且联合组下降更明显(P<0.05)。联合组总有效率为96.51%(83/86)高于对照组的87.80%(72/82),差异有统计学意义(P<0.05)。联合组不良反应率为4.65%(4/86)与对照组的3.66%(3/82)比较,差异无统计学意义(P>0.05)。结论:硝苯地平联合依那普利治疗老年冠心病伴高血压可调节患者血脂代谢及CTRP3、sVCAM-1的表达,改善血管内皮功能,提高疗效。

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关键词 ：冠心病伴高血压, 硝苯地平, 依那普利, 血脂代谢, 血管内皮功能

Abstract：Objective: To observe the effect of nifedipine combined with enalapril on vascular endothelial function, lipid metabolism and inflammatory reaction in elderly patients with coronary artery disease and hypertension. Methods: A total of 168 elderly patients with coronary heart disease and hypertension admitted to Zhangye People's Hospital Affiliated to Hexi University from January 2020 to July 2021 were selected as subjects and divided into two groups by odd-even random method. Eighty-two patients in the control group received nifedipine treatment, and 86 patients in the combination group received enalapril treatment on the basis of the control group. The differences of lipid metabolism, vascular endothelial function and inflammatory response were compared between the two groups, and the efficacy and safety of the two groups were evaluated. Results: There was no significant difference in blood lipid metabolism, vascular endothelium-related factors and inflammatory factors between the two groups before treatment (P>0.05); Compared with before treatment, the levels of high-density lipoprotein cholesterol (HDL-C), nitric oxide (NO), apolipoprotein A1 (Apo-A1), C1q tumor necrosis factor associated protein 3 (CTRP3) and apolipoprotein B (Apo-B) in the two groups increased after treatment, and the combined group increased more significantly than the control group (P<0.05); Total cholesterol (TC), endothelin (ET), soluble vascular adhesion factor-1 (sVCAM-1), triglyceride (TG), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), low-density lipoprotein cholesterol (LDL-C), lipoprotein (a) [LP (a)] in the two groups decreased after treatment, and the decrease in the combined group was more significant than that in the control group (P<0.05). The total effective rate of the combined group was 96.51% (83/86), which was higher than 87.80% (72/82) of the control group, with a statistical difference (P<0.05). The adverse reaction rate of the combination group was 4.65% (4/86), compared with 3.66% (3/82) of the control group, there was no statistical difference (P>0.05). Conclusion: Nifedipine combined with enalapril in the treatment of elderly coronary artery disease with hypertension can regulate the metabolism of blood lipids and the expression of CTRP3, sVCAM-1, improve the endothelial function, and improve the efficacy.

Key words： Coronary heart disease with hypertension Nifedipine Enalapril Blood lipid metabolism Vascular endothelial function

基金资助:2021甘肃省中医药科研项目,(编号:GZKP-2021-42)

通讯作者: 宋玉霞

引用本文:

田拂晓, 武小琴, 王晶, 张小岑, 宋玉霞. 硝苯地平联合依那普利对老年冠心病伴高血压患者血脂代谢血管内皮功能及炎症反应的影响[J]. 河北医学, 2023, 29(5): 867-872.
TIAN Fuxiao, WU Xiaoqin, WANG Jing, et al. Effects of Nifedipine Combined with Enalapril on Blood Lipid Metabolism Vascular Endothelial Function and Inflammatory Response in Elderly Patients with Coronary Artery Disease and Hypertension. HeBei Med, 2023, 29(5): 867-872.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.05.033 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I5/867

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