中国临床药学杂志2025，Vol.34Issue(4)：289-295,7.DOI:10.19577/j.1007-4406.2025.04.009
尼可地尔辅助治疗老年2型糖尿病合并心绞痛的临床疗效
Effects of nicorandil as an adjuvant therapy for elderly patients with T2DM complicated with angina pectoris
摘要
Abstract
AIM To analyze the therapeutic effect of nicorandil in elderly patients with type 2 diabetes mellitus(T2DM)complicated with angina pectoris,as well as its impact on heart rate variability,oxidative/antioxidant indicators,and Seattle angina questionnaire(SAQ)scores.METHODS A total of 105 elderly patients with T2DM complicated with angina pectoris from January 2021 to January 2023 were selected from the hospital.They were randomly divided into a control group(n=52)and an observation group(n=53).Both groups were given standard hypoglycemic therapy.The control group received the standard secondary prevention treatment for coronary heart disease,while the observation group received nicorandil based on the control group.All patients were treated for 6 months.The efficacy of angina pectoris,the frequency and duration of angina pectoris attacks,adverse reactions,major adverse cardiovascular events(MACE),heart rate variability[root mean square of successive RR-interval differences(RMSSD),standard deviation of normal R-R intervals(SDNN),percentage of adjacent R-R intervals differing by more than 50 ms(pNN50)],nuclear factor erythroid 2-related factor 2-antioxidant responsive element(Nrf2-ARE)signaling pathway[ARE,Nrf2,quinone oxidoreductase(NQO1),Kelch-like ECH-associated protein 1(Keap1)],oxidation/antioxidation indicators[8-hydroxydeoxyguanosine(8-OHdG),catalase(CAT),malondialdehyde(MDA),superoxide dismutase(SOD)],blood glucose levels,and SAQ scores were statistically analyzed in both groups.RESULTS After 6 months of treatment,the total effective rate of the observation group(90.57％)was higher than that of the control group(75.00％),and the difference was statistically significant(P＜0.05).After 3 and 6 months of treatment,the observation group showed higher RMSSD,SDNN,and pNN50 values compared to the control group,with significant differences(P＜0.05).Additionally,they experienced fewer and shorter angina attacks and had higher SAQ scores than the control group,with these differences being statistically significant(P＜0.05).After 3 and 6 months of treatment,the ARE,Nrf2,NQO1,SOD,and CAT in the observation group were higher than those in the control group,while Keap1,MDA,8-OHdG,fasting blood glucose,2-hour postprandial blood glucose,and glycosylated hemoglobin were lower than those in the control group,with statistically significant differences(P＜0.05).The total incidence of MACE and other adverse reactions in the observation group were 5.66％and 9.43％,respectively,which showed no significant difference compared with the control group(P＞0.05).CONCLUSION Nicorandil is effective in assisting elderly patients with T2DM and angina pectoris,improving heart rate variability,alleviating angina symptoms,and improving quality of life.It is highly safe and may be related to regulating the Nrf2-ARE signaling pathway and stabilizing the balance between oxidation and antioxidation.关键词
尼可地尔/2型糖尿病/心绞痛/心率变异性/核因子E2相关因子2-抗氧化反应元件信号通路/主要不良心血管事件Key words
nicorandi/type 2 diabetes mellitus/angina pectoris/heart rate variability/Nrf2-ARE signaling pathway/major adverse cardiovascular events分类
药学引用本文复制引用
边亚,刘广阔,曹卫广,郭洁,孙耀东..尼可地尔辅助治疗老年2型糖尿病合并心绞痛的临床疗效[J].中国临床药学杂志,2025,34(4):289-295,7.基金项目
河北省卫生健康委科研项目(编号20201345) （编号20201345）
