摘要
Abstract
Objective:To evaluate the clinical efficacy of nicorandil combined with trimetazidine in patients with type 2 diabetes mellitus(T2DM)complicated with coronary heart disease(CHD),and to explore its effects on vascular endothelial function,blood lipids,and inflammatory factors.Methods:A randomized controlled trial was conducted involving 472 patients with T2DM and CHD admitted to the First People's Hospital of Foshan from February 2022 to February 2024.Participants were divided using a random number table into a control group(nicorandil monotherapy,n=236)and an experimental group(nicorandil combined with trimetazidine,n=236),with a treatment course of 3 months.Changes in vascular endothelial function indicators[nitric oxide(NO),endothelin-1(ET-1),vascular endothelial growth factor(VEGF),thromboxane B2(TXB2)],blood lipid parameters[total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],and inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)]were compared before and after treatment.A generalized linear regression model was used to analyze influencing factors of vascular endothelial function.Results:After treatment,the experimental group showed better improvement in vascular endothelial function than the control group,characterized by higher NO and VEGF levels,and lower ET-1 and TXB2 levels(P<0.05).Meanwhile,the experimental group also demonstrated superior performance in regulating blood lipids(reduced TC,TG,and LDL-C;increased HDL-C)and reducing inflammatory factor levels(P<0.05).Generalized linear regression analysis indicated that treatment group(experimental group),duration of diabetes,changes in TG,and changes in LDL-C were independent influencing factors for improvement in vascular endothelial function(P<0.05).Conclusion:Nicorandil combined with trimetazidine can more effectively improve vascular endothelial function,lipid metabolism,and inflammatory status in patients with T2DM and CHD,with efficacy superior to nicorandil monotherapy.关键词
尼可地尔/曲美他嗪/2型糖尿病/冠心病/血管内皮功能Key words
nicorandil/trimetazidine/type 2 diabetes mellitus/coronary heart disease/vascular endothelial function分类
医药卫生
