摘要
目的探讨替格瑞洛联合阿托伐他汀治疗冠心病不稳定型心绞痛的疗效及对心功能和脑钠肽(BNP)、脂蛋白相关性磷脂酶A2(Lp-PLA2)、糖化血红蛋白(HbAlc)水平的影响。方法选择2017年1月至2019年1月杭州明州医院接诊的冠心病不稳定型心绞痛患者200例作为研究对象, 采用随机数字表法分为对照组和观察组, 每组100例。对照组给予氯吡格雷联合阿托伐他汀治疗, 观察组给予替格瑞洛联合阿托伐他汀治疗。治疗1个月后, 比较两组临床疗效和治疗前后BNP、Lp-PLA2、HbAlc、临床症状发作情况、心功能变化情况及不良反应发生情况。结果观察组有效率为95%(95/100), 明显高于对照组的75%(75/100), 差异有统计学意义(χ^(2)=15.69, P < 0.001)。治疗后观察组BNP、Lp-PLA2水平分别为(101.21±40.13)ng/L、(105.56±12.56)pg/L, 均明显低于对照组的(151.57±37.29)ng/L、(137.52±16.88)pg/L, 均差异有统计学意义(t=9.19、15.19, P < 0.001);治疗后观察组心绞痛持续时间、发作次数分别为(1.84±0.49)min/次、(1.32±0.21)次/周, 均明显低于对照组的(5.23±1.72)min/次、(3.58±0.71)次/周, 均差异有统计学意义(t=18.95、30.52, 均P < 0.001);治疗后观察组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)水平分别为(33.28±1.21)mm、(47.89±5.61)mm, 均明显低于对照组的(37.56±2.14)mm、(53.25±5.07)mm, 观察组LVEF为(48.59±5.81)%, 高于对照组的(41.16±5.83)%, 均差异有统计学意义(t=17.41、7.09、9.03, 均P < 0.001)。观察组不良反应发生率为1%(1/100), 明显高于对照组的12%(12/100), 差异有统计学意义(χ^(2)=9.96, P=0.002)。结论替格瑞洛联合阿托伐他汀治疗冠心病不稳定型心绞痛的疗效显著, 可有效改善患者BNP、Lp-PLA2水平, 值得推广应用。
Objective To investigate the efficacy of ticagrelor combined with atorvastatin in the treatment of unstable angina pectoris and its effects on cardiac function,brain natriuretic peptide(BNP)level,lipoprotein-associated phospholipase A2(Lp-PLA2)activity,and glycosylated hemoglobin(HbAlc)level in patients with unstable angina pectoris.Methods A total of 200 patients with unstable angina pectoris who received treatment in the Sahzu International Medical Center from January 2017 to January 2019 were included in this study.These patients were randomly assigned to receive either clopidogrel combined with atorvastatin(control group,n=100)or ticagrelor combined with atorvastatin(observation group,n=100)for 1 month.The clinical efficacy,BNP level,Lp-PLA2 activity,HbAlc level,clinical symptom,cardiac function,and adverse reactions were compared between control and observation groups.Results Effective rate was significantly higher in the observation group than in the control group[95%(95/100)vs.75%(75/100),χ^(2)=15.69,P<0.001].After treatment,BNP level and Lp-PLA2 activity in the observation group were(101.21±40.13)ng/L and(105.56±12.56)pg/L,respectively,which were significantly lower than those in the control group[(151.57±37.29)ng/L,(137.52±16.88)pg/L,t=9.19,15.19,P<0.001].After treatment,the duration and frequency of angina pectoris in the observation group were(1.84±0.49)minutes/time and(1.32±0.21)times/week,respectively,which were significantly lower than those in the control group[(5.23±1.72)minutes/time and(3.58±0.71)times/week,t=18.95,30.52,both P<0.001].After treatment,the left ventricular end-diastolic diameter and left ventricular end-systolic diameter in the observation group were(33.28±1.21)mm and(47.89±5.61)mm respectively,which were significantly lower than those in the control group[(37.56±2.14)mm,(53.25±5.07)mm,t=17.41,7.09,both P<0.001].Left ventricular ejection fraction was significantly higher in the observation group than in the control group[(48.59±5.81)%vs.(41.16±5.83)%,t=9.03,P<0.001].The incidence of adverse reactions was significantly higher in the observation group than in the control group[1%(1/100)vs.12%(12/100),χ^(2)=9.96,P=0.002].Conclusion Ticagrelor combined with atorvastatin is highly effective for unstable angina pectoris in coronary heart disease because it greatly decreases BNP level and Lp-PLA2 activity.Therefore,the combined therapy deserves clinical promotion.
作者
许惠菊
余传银
Xu Huiju;Yu Chuanyin(Grade 2020,Graduate School of Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang Province,China;Department of Cardiology,Xiaoshan Hospital of Traditional Chinese Medicine,Hangzhou 300201,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2022年第1期33-37,共5页
Chinese Journal of Primary Medicine and Pharmacy
