缬沙坦联合他汀类药物治疗冠心病的效果分析
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摘要
目的探讨缬沙坦联合他汀类药物治疗冠心病的效果及对脑钠肽(BNP)、C反应蛋白(CRP)水平的影响。方法将2015年3月至2017年3月该院收治的92例冠心病患者作为研究对象,并随机分为研究组46例和对照组46例。两组患者均给予常规治疗,对照组在常规治疗基础上给予缬沙坦40mg/d,口服;用药3d后,若未发生低血压,剂量增至80mg/d;研究组在对照组治疗基础上联合应用阿托伐他汀钙胶囊20mg/d,晚餐后0.5h顿服。两组患者疗程均为6个月。比较治疗前后血脂、冠状斑块、左心室射血分数(LVEF)、BNP及CRP水平的变化,并记录不良事件发生情况。结果治疗后研究组TG、TC、LDL-C明显低于对照组,HDLC、LVEF明显高于对照组,差异均有统计学意义(P<0.05);研究组脂质斑块、纤维斑块、钙化斑块、混合斑块明显低于对照组,差异均有统计学意义(P<0.05);治疗后研究组BNP、CRP明显低于对照组差异均有统计学意义(P<0.05);两组患者治疗过程中均发生急性心肌梗死、不稳定型心绞痛、心功能衰竭等不良事件,组间比较差异有统计学意义(P<0.05)。结论缬沙坦联合他汀类药物治疗冠心病,能够有效调节患者血脂水平,减小冠状斑块面积,抑制炎性反应的发生。
Objective Investigate the effect of valsartan combined with statins on coronary heart disease and its effect on BNP and CRP.Methods 92 cases of patients with coronary heart disease were selected,which were treated in hospital from March 2015 to March 2017,and were divided into the study group(46 cases)and control group(46 cases).The patients of all two groups were treated with conventional treatment.The patients of control group were treated with valsartan(40 mg/d,oral;if no hypotension after 3 days of treatment,the dose increased to 80 mg/d),and on the basis of control group,the patients of study group were treated with atorvastatin calcium capsules(20 mg/d,in 0.5 hafter dinner).The patients of two groups were all treated for 6 months in a row.Compare the adverse reactions and changes of the levels of blood lipids,coronary plaques,BNP,CRP and LVEF of two groups.Results After the appropriate treatment,the TG,TC,LDL-C levels of the study group were significantly lower than those of the control group,and the HDL-C,LVEF levels of the study group were significantly higher than those of the control group(P<0.05);the lipid plaque,fibrous plaque,calcified plaque,mixed plaque levels of the study group were significantly lower than those of the control group(P<0.05);The BNP,CRP levels of the study group were significantly lower than those of the control group(P<0.05);There were acute myocardial infarction,unstable angina,heart failure and other adverse events occurred in both two groups,and the difference was statistically significant between the two groups(P<0.05).Conclusion Valsartan combined with statins in the treatment of patients with coronary heart disease can improve blood lipid levels,reduce coronal plaque area,inhibit inflammatory response,which makes it worthy of clinical promotion.
Objective Investigate the effect of valsartan combined with statins on coronary heart disease and its effect on BNP and CRP.Methods 92 cases of patients with coronary heart disease were selected,which were treated in hospital from March 2015 to March 2017,and were divided into the study group(46 cases)and control group(46 cases).The patients of all two groups were treated with conventional treatment.The patients of control group were treated with valsartan(40 mg/d,oral;if no hypotension after 3 days of treatment,the dose increased to 80 mg/d),and on the basis of control group,the patients of study group were treated with atorvastatin calcium capsules(20 mg/d,in 0.5 hafter dinner).The patients of two groups were all treated for 6 months in a row.Compare the adverse reactions and changes of the levels of blood lipids,coronary plaques,BNP,CRP and LVEF of two groups.Results After the appropriate treatment,the TG,TC,LDL-C levels of the study group were significantly lower than those of the control group,and the HDL-C,LVEF levels of the study group were significantly higher than those of the control group(P<0.05);the lipid plaque,fibrous plaque,calcified plaque,mixed plaque levels of the study group were significantly lower than those of the control group(P<0.05);The BNP,CRP levels of the study group were significantly lower than those of the control group(P<0.05);There were acute myocardial infarction,unstable angina,heart failure and other adverse events occurred in both two groups,and the difference was statistically significant between the two groups(P<0.05).Conclusion Valsartan combined with statins in the treatment of patients with coronary heart disease can improve blood lipid levels,reduce coronal plaque area,inhibit inflammatory response,which makes it worthy of clinical promotion.
引文
[1] FOSTER M C,RAWLINGS A M,MARRETT E,et al.Potential effects of reclassifying CKD as a coronary heart disease risk equivalent in the us population[J].Am J Kidney Dis,2014,63(5):753-760.
[2] VAN K B,FERKET B S,KAVOUSI M,et al.Performance of Framingham cardiovascular disease(CVD)predictions in the Rotterdam Study taking into account competing risks and disentangling CVD into coronary heart disease(CHD)and stroke[J].Int J Cardiol,2014,171(3):413-418.
[3] HEVEY D,MCGEE H M,HORGAN J H,et al.Comparative optimism among patients with coronary heart disease(CHD)is associated with fewer adverse clinical events 12months later[J].J Behav Med,2014,37(2):300-307.
[4]王三宝,赵洛莎.早发冠心病患者的危险因素及冠脉病变特点研究[J].中国实验诊断学,2014,18(7):1094-1097.
[5]廖火城,钟思干,刘凌,等.冠心病预测评分系统的建立及评价[J].山东医药,2016,56(31):58-60.
[6]蔡运昌,吴强.《2013年ACC/AHA心血管风险评估指南》解读[J].中国循环杂志,2014,16(2):91-95.
[7]JANSEN M D,KNUDSEN G P,MYHRE R,et al.Genetic variants in loci 1p13and 9p21and fatal coronary heart disease in a Norwegian case-cohort study[J].Mol Biol Rep,2014,41(5):2733-2743.
[8]赵洁,吴俊,贾玫,等.冠心病患者血液脂蛋白相关磷脂酶A2与超敏C反应蛋白及D-二聚体的相关性研究[J].中华检验医学杂志,2014,37(3):227-229.
[9]赖天寿,丘仲柳,谭柏松,等.冠心病患者血清hs-CRP﹑cTnI和血脂水平变化及临床意义[J].中国实验诊断学,2014,18(1):49-51.
[10]陈懿,徐世鄂.瑞舒伐他汀和阿托伐他汀对冠心病患者的调脂作用和安全性比较[J].中国老年学杂志,2014,34(9):2389-2390.
[11]祝小霞,丁旵东,曾胜煌,等.冠状动脉狭窄程度与冠心病危险因素的相关性分析[J].中华老年心脑血管病杂志,2014,16(3):267-270.
[12]赵伟,李婷婷,李莹,等.冠心病患者炎性因子水平与急性冠状动脉综合征的相关性分析[J].中华老年心脑血管病杂志,2014,16(2):207-208.
[13]何荣华,岳新荣.缬沙坦对冠心病患者血清hs-CRP和颈动脉斑块的影响[J].安徽医药,2015,19(2):382-384.
[14]蒙涛,马树人,谷阳,等.缬沙坦对冠心病合并高血压患者血浆线粒体转录因子A的影响及临床治疗效果[J].岭南心血管病杂志,2016,22(6):687-690.
[15]唐慧芸,王烨,姜盈缨,等.脂蛋白(a)与稳定性冠心病的关系及他汀类药物对其水平的影响研究[J].中国全科医学,2016,19(6):666-671.
[2] VAN K B,FERKET B S,KAVOUSI M,et al.Performance of Framingham cardiovascular disease(CVD)predictions in the Rotterdam Study taking into account competing risks and disentangling CVD into coronary heart disease(CHD)and stroke[J].Int J Cardiol,2014,171(3):413-418.
[3] HEVEY D,MCGEE H M,HORGAN J H,et al.Comparative optimism among patients with coronary heart disease(CHD)is associated with fewer adverse clinical events 12months later[J].J Behav Med,2014,37(2):300-307.
[4]王三宝,赵洛莎.早发冠心病患者的危险因素及冠脉病变特点研究[J].中国实验诊断学,2014,18(7):1094-1097.
[5]廖火城,钟思干,刘凌,等.冠心病预测评分系统的建立及评价[J].山东医药,2016,56(31):58-60.
[6]蔡运昌,吴强.《2013年ACC/AHA心血管风险评估指南》解读[J].中国循环杂志,2014,16(2):91-95.
[7]JANSEN M D,KNUDSEN G P,MYHRE R,et al.Genetic variants in loci 1p13and 9p21and fatal coronary heart disease in a Norwegian case-cohort study[J].Mol Biol Rep,2014,41(5):2733-2743.
[8]赵洁,吴俊,贾玫,等.冠心病患者血液脂蛋白相关磷脂酶A2与超敏C反应蛋白及D-二聚体的相关性研究[J].中华检验医学杂志,2014,37(3):227-229.
[9]赖天寿,丘仲柳,谭柏松,等.冠心病患者血清hs-CRP﹑cTnI和血脂水平变化及临床意义[J].中国实验诊断学,2014,18(1):49-51.
[10]陈懿,徐世鄂.瑞舒伐他汀和阿托伐他汀对冠心病患者的调脂作用和安全性比较[J].中国老年学杂志,2014,34(9):2389-2390.
[11]祝小霞,丁旵东,曾胜煌,等.冠状动脉狭窄程度与冠心病危险因素的相关性分析[J].中华老年心脑血管病杂志,2014,16(3):267-270.
[12]赵伟,李婷婷,李莹,等.冠心病患者炎性因子水平与急性冠状动脉综合征的相关性分析[J].中华老年心脑血管病杂志,2014,16(2):207-208.
[13]何荣华,岳新荣.缬沙坦对冠心病患者血清hs-CRP和颈动脉斑块的影响[J].安徽医药,2015,19(2):382-384.
[14]蒙涛,马树人,谷阳,等.缬沙坦对冠心病合并高血压患者血浆线粒体转录因子A的影响及临床治疗效果[J].岭南心血管病杂志,2016,22(6):687-690.
[15]唐慧芸,王烨,姜盈缨,等.脂蛋白(a)与稳定性冠心病的关系及他汀类药物对其水平的影响研究[J].中国全科医学,2016,19(6):666-671.
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