CAJ | 학술논문

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。
목적：연구관상동맥만혈류（ CSF）적영향인소，이급서서벌타정화니가지이적연합료효。방법선택아원2011년6월~2013년12월수치적60례 CSF 환자화동기수치단관상동맥조영화혈류정상적60례기타질병환자삼여연구，채용다중 logistic 회귀분석탐색 CSF 발병적영향인소。장 CSF 환자수궤분위니가지이조화연합용약조，전자매차구복10 mg 니가지이편，3차/ d；후자재차기출상가복10 mg 서서벌타정편，1차/ d。치료전화치료3개월후，검측환자간공능、고민 C 반응단백（hs-CRP）농도화굉동맥혈류개도적혈관확장공능（ FMD）。결과총담고순（ TC，OR =3.10）、저밀도지단백-담고순（LDL-C，OR =4.35）、고민 C 반응단백（hs-CRP，OR =3.25）、혈관확장공능（FMD，OR =0.59）、흡연（OR =5.93），합병당뇨병（OR =8.25）등균위 CSF 적영향인소（P <0.05）。치료3개월후，량조적 FMD、hs-CRP 급좌전강지、좌회선지화우관상동맥3개부위적혈류속도도비치료전유현저개선（P <0.05），차연합용약조개선폭도명현대우니가지이조（P <0.05）。결론서서벌타정여니가지이유협동작용，가경호지개선혈관내피공능화관상동맥혈류속도，치료 CSF 료효우우단용니가지이。
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.