唑吡坦对中青年冠心病稳定性心绞痛伴自述失眠患者的影响

目的： 观察唑吡坦对中青年冠心病稳定性心绞痛（SAP）伴自述失眠患者的疗效及安全性，并探讨其相关机制。方法： 选取2017年1月-2018年12月收治的青中年冠心病SAP伴自述失眠患者118例为研究对象，用随机数字表法将其分为对照组和治疗组，每组各59例。2组均给予SAP一般用药，治疗组在SAP一般用药基础上加用唑吡坦10 mg睡前口服，对照组则给予同等样式安慰剂。治疗4周后比较2组治疗前后心型脂肪酸结合蛋白（H-FABP）、C反应蛋白（CRP）和脂蛋白相关磷脂酶A2（Lp-PLA₂）水平，评价SAP治疗效果。并运用匹兹堡睡眠质量指数（PSQI）和国际统一睡眠效率公式评估患者的睡眠质量，同时观察不良反应发生情况。结果： 治疗前2组H-FABP、CRP和Lp-PLA₂水平比较无统计学差异（P>0.05），治疗后2组H-FABP、CRP和Lp-PLA₂水平均有所下降，但对照组下降不明显（P>0.05），治疗组下降明显（P<0.05），治疗组下降水平高于对照组（P<0.05）。治疗后2组的PSQI各因子及总计评分均有下降，但对照组下降无显著差异（P>0.05），治疗组较前下降明显（P<0.05），组间比较存在差异（P<0.05）。治疗组自述失眠临床总有效率为91.5%，优于对照组的67.8%（P<0.05）；治疗组SAP治疗总有效率为91.5%，优于对照组的71.2%（P<0.05）。治疗组和对照组的不良反应发生率分别为6.8%和5.1%（P>0.05），2组均无明显影响治疗的不良反应发生。结论： 唑吡坦治疗中青年冠心病SAP伴自述失眠患者疗效显著，能明显改善患者SAP治疗效果和睡眠质量，且安全性较高，具有临床推广价值。

Clinical efficacy of zolpideminon young and middle-aged patients with stable angina pectoris and self-reported insomnia

OBJECTIVE To observe the clinical efficacy and safety of zolpidem on young and middle-aged patients with stable angina pectoris (SAP) complicated with self-reported insomnia, and to explore its related mechanism.METHODS 118 young-middle-aged SAP patients with self-reported insomnia admitted hospital from January 2017 to December 2018 were selected as the study subjects. The subjects were divided into control group and treatment group (n=59 for each) by random number table. Both groups were given SAP general medication. The patients in the treatment group were given 10 mg zolpidem orally before bedtime as well, while the patients in the control group were given an equivalent dose of oral placebo. After treatment for 4 weeks, the levels of cardiac fatty acid binding protein (H-FABP), C-reactive protein (CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA₂) were compared between 2 groups to evaluate the clinical efficacy of SAP before and after treatment. The Pittsburgh sleep quality index (PSQI) and the international uniform sleep efficiency formula were used to evaluate all patients' sleep quality, and the adverse reactions were also observed.RESULTS Before treatment, the levels of H-FABP, CRP and Lp-PLA₂ in both groups showed no statistical difference (P>0.05). After treatment, the levels of H-FABP, CRP and Lp-PLA₂ decreased in both groups, but there was no significant decrease in the control group (P>0.05). The decrease in the treatment group was significant (P<0.05). The decrease in the treatment group was higher than that in the control group (P<0.05). After treatment, the PSQI factors and total scores of the two groups decreased, but there was no significant difference in the decrease in the control group (P>0.05). The decrease was significant before treatment (P<0.05). There was significant difference between the two groups (P<0.05).The total effective rate of insomnia in the treatment group was 91.5%, which was superior to 67.8% in the control group (P<0.05); the total effective rate of SAP treatment in the treatment group was 91.5%, which was superior to 71.2% in the control group (P<0.05).The incidence of adverse reactions in the treatment group was 6.8% and 5.1%, respectively (P>0.05).CONCLUSION Zolpidem is effective in the treatment of young and middle-aged patients with SAP complicated with self-reported insomnia, and can significantly improve the therapeutic effect and sleep quality of SAP with a high safety profile. It has the value of clinical promotion.