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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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

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

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