【摘要】 目的:观察应用酒石酸伐尼克兰干预尼古丁依赖的急性冠状动脉综合征(ACS)患者戒断烟草依赖后血管内皮功能和炎性细胞因子的变化情况,了解药物戒断治疗对尼古丁依赖的ACS患者血管内皮功能和炎性细胞因子的影响。方法:入选在本院心血管内科住院、吸烟超过10支/d、吸烟10年以上、中度及中度以上尼古丁依赖的ACS确诊患者,随机分为药物戒断组(入院后即给予口服酒石酸伐尼克兰)和干戒组(不应用药物辅助戒断),维持治疗2周,均配合每日10~30 min的宣教及戒烟咨询。入选时采集全部患者的基线水平,同时留血标本检测一氧化氮(NO)、白细胞介素-6(IL-6)和内皮素-1(ET-1)水平,治疗2周后复测。结果:共入选104例符合入选标准的ACS患者,药物戒断组和干戒组各52例。治疗后,两组患者的ET-1水平[药物戒断组:(33.950±1.439)ng/L vs(170.198±12.602)ng/L;干戒组:(60.795±7.036)ng/L vs(170.511±12.374)ng/L]以及药物戒断组的IL-6水平[(0.103±0.020)ng/L vs(0.307±0.051)ng/L]均较治疗前显著降低,差异有统计学意义(P<0.05);两组患者治疗后的NO水平较治疗前稍降低,但差异均无统计学意义(P>0.05)。治疗后,药物戒断组患者的ET-1[(33.950±1.439)ng/L vs(60.795±7.036)ng/L]及IL-6水平[(0.103±0.020)ng/L vs(0.258±0.042)ng/L]较干戒组明显下降,差异有统计学意义(P<0.05),但NO水平的组间差异无统计学意义(P>0.05)。结论:本研究提示,与不用药干戒相比,应用酒石酸伐尼克兰戒断可以有效地抑制尼古丁依赖ACS患者血浆细胞炎性因子的释放,并改善患者血管内皮功能,对患者有心血管保护作用。更多还原

【Abstract】 Objective: To observe the impact of vareniline tartrate on vascular endothelial function and inflammatory factor releasing in acute coronary syndrome(ACS) patients with nicotine dependence after smoking withdrawal treatment.Methods: We recruited the in-hospital ACS patients who were smoking ≥10 cigarettes/day for more than 10 years with at least moderate nicotine dependence, and randomly divided them into 2 groups: Varenicline group, the patients received oral medication for 2 weeks and Self withdrawal group, the patients without medication assistance. n=52 in each group. All patients received(10-30) min daily mission and consulting for quit smoking for 2 weeks. The basic information was recorded and blood levels of NO, IL-6 and ET-1 were compared before and after withdrawal treatment. Results: Compared with they were before, after 2 weeks withdrawal treatment, in Varenicline group, blood levels of ET-1 decreased as(33.950 ± 1.439) ng/L vs(170.198 ± 12.602) ng/L and IL-6 decreased as(0.103 ± 0.020) ng/Lvs(0.307 ± 0.051) ng/L; in Self withdrawal group, ET-1 decreased as(60.795 ±7.036) ng/L vs(170.511 ± 12.374) ng/L, all P<0.05; while NO levels were similar, P>0.05. After treatment, ET-1 level in Varenicline group(33.950 ± 1.439) ng/L was lower than Self withdrawal group(60.795 ± 7.036) ng/L and IL-6 level in Varenicline group(0.103 ± 0.020) ng/L was also lower than Self withdrawal group(0.258 ± 0.042) ng/L, all P<0.05; while NO levels were similar between 2 groups, P>0.05.Conclusion: Compared with self withdrawal, varenicline tartrate may effectively inhibit inflammatory factor releasing in ACS patients with nicotine dependence, and therefore improve the vascular endothelial function.更多还原