目的 探討煙酸注射液聯合硝酸甘油注射液治療不穩(wěn)定型心絞痛的臨床療效。方法 回顧性分析2019年2月—2023年2月在西安交通大學附屬紅會醫(yī)院治療的118例不穩(wěn)定型心絞痛患者的臨床資料。根據用藥種類的不同分為對照組和治療組，每組各59例。對照組靜脈輸入硝酸甘油注射液，20 mL加入5%葡萄糖注射液50 mL，初始劑量5 μg/min，根據病情調整劑量，1次/d；在此基礎上，治療組肌肉注射煙酸注射液，100 mg/次，5次/d。兩組患者均進行7 d治療。觀察兩組患者臨床療效，比較治療前后兩組患者心絞痛發(fā)作次數及持續(xù)時間，血凝素樣氧化低密度脂蛋白受體1（Lox-1）、I型膠原吡啶交聯終肽（ICTP）、心肌營養(yǎng)素-1（CT-1）、血栓烷素B₂（TXB₂）、B淋巴細胞瘤/白血病-2（Bcl-2）、脂聯素（APN）、總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）、高密度脂蛋白膽固醇（HDL-C）、肌酸激酶（CK）、α-羥基丁酸脫氫酶（HBDH）、肌酸激酶同功酶（CK-MB）和乳酸脫氫酶（LDH）水平。結果 治療后，治療組臨床有效率（98.31%）明顯高于對照組（81.36%，P＜0.05）。治療后，兩組心絞痛發(fā)作次數、每次持續(xù)時間均減少（P＜0.05），且治療組減少最顯著（P＜0.05）。治療后，兩組患者血清Lox-1、ICTP、CT-1、TXB₂、TC、TG、LDL-C、CK、HBDH、CK-MB和LDH水平均明顯下降，而Bcl-2、APN、HDL-C水平明顯增高（P＜0.05），且治療組這些指標比對照組改善更明顯（P＜0.05）。結論 煙酸注射液聯合硝酸甘油注射液治療不穩(wěn)定型心絞痛可有效緩解臨床癥狀，促進心功能、血脂、血清細胞因子水平改善。

Objective To explore the clinical efficacy of Nicotinic Acid Injection combined with nitroglycerin in treatment of unstable angina pectoris. Methods Patients (118 cases) with unstable angina pectoris in Honghui Hospital Affiliated to Xi'an Jiaotong University from February 2019 to February 2023 were divided into control and treatment group based on different treatments, and each group had 59 cases. Patients in the control group were iv administered with Nitroglycerin Injection, 20 mL added into 5% glucose injection 50 mL, the initial dose was 5 μg/min, adjusted the dose according to the condition, once dayly. Patients in the treatment group were intramuscular injection administered with Nicotinic Acid Injection on the basis of the control group, 100 mg/time, five times daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, and the frequency and duration of angina pectoris, the levels of Lox-1, ICTP, CT-1, TXB₂, Bcl-2, APN, TC, TG, LDL-C, HDL-C, CK, HBDH, CK-MB and LDH in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (98.31%) was significantly higher than that of the control group (81.36%, P < 0.05). After treatment, the attack times and duration of angina pectoris were significantly decreased in two groups (P < 0.05), and which in the treatment group decreased more significant than that in the control group (P < 0.05). After treatment, the serum levels of Lox-1, ICTP, CT-1, TXB₂, TC, TG, LDL-C, CK, HBDH, CK-MB and LDH were significantly decreased, while the levels of Bcl-2, APN and HDL-C were significantly increased in two groups (P< 0.05), and the improvement of these indexes in the treatment group was more obvious than that in the control group (P < 0.05). Conclusion Nicotinic Acid Injection combined with nitroglycerin can effectively relieve clinical symptoms and improve cardiac function, blood lipids and serum cytokines in treatment of unstable angina pectoris.

R972