不稳定性心绞痛患者急性血管闭塞与血管性血友病因子和一氧化氮水平相关性以及阿托伐他汀干预效果临床研究
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摘要
目的 :探讨不稳定性心绞痛(UAP)患者急性血管闭塞与血管性血友病因子(vWF)和一氧化氮(NO)水平的相关性以及阿托伐他汀对患者的干预效果。方法:选择80例UAP急性血管闭塞患者作为研究对象。采用随机数字表分组法将患者分为对照组和观察组,各组40例。对照组给予口服阿司匹林、依那普利及硝酸异山梨酯治疗,观察组在对照组基础上给予阿托伐他汀钙治疗,比较两组治疗后临床疗效、血脂水平、vWF、NO及心脏舒张功能指标(E/A)水平变化,并应用Spearman分析急性血管闭塞与vWF和NO水平的相关性。结果 :治疗前,两组三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、vWF、NO及E/A等水平比较差异无统计学意义(P>0.05);治疗后,两组TG、TC、LDL-C、vWF、E/A指标水平均降低,HDL-C、NO水平均升高(P<0.05);观察组治疗后TG、TC、LDL-C、vWF、E/A指标水平低于对照组,HDL-C、NO水平高于对照组(P<0.05);观察组总有效率87.50%(35/40)明显高于对照组67.50%(27/40)(P<0.05);vWF水平与急性血管闭塞成正相关性(r=0.536,P<0.05);NO水平与急性血管闭塞成负相关性(r=-0.419,P<0.05)。结论:阿托伐他汀可显著改善不稳定性心绞痛急性血管闭塞患者血脂、vWF、NO、E/A等指标水平,临床疗效满意,急性血管闭塞与vWF水平成正相关性,与NO水平成负相关性。临床上通过检测血浆vWF、NO含量,可为不稳定性心绞痛患者早期诊断及临床治疗提供一定的指导依据。
Objective: To investigate the correlation between acute vascular occlusion and levels of vWF and NO in patients with unstable angina pectoris and the effect of atorvastatin on patients.Methods: 80 patients with UAP with acute vascular occlusion were selected as the subjects. The patients were divided into control group and observation group by random number table grouping method,40 cases in each group.The control group was treated with aspirin,enalapril and isosorbide dinitrate. The observation group was treated with atorvastatin calcium on the basis of the control group. The clinical efficacy,blood lipid levels,vWF,NO and E/A levels were compared between the two groups. Spearman was used to analyze the correlation between acute vascular occlusion and vWF and NO levels.Results: There was no significant difference in the levels of TG,TC,LDL-C,HDL-C,vWF,NO and E/A between the two groups before and after treatment(P>0.05). After treatment,the levels of TG,TC,LDL-C,vWF,E/A were decreased,while the levels of HDL-C and NO were increased in both groups(P<0.05). Group HDL-C and NO levels were higher than those in control group(P<0.05).The total effective rate of the observation group was 87.50%(35/40) significantly higher than that of the control group(67.50%(27/40)(P<0.05); the level of vWF was positively correlated with acute vascular occlusion(r=0.536,P<0.05); the level of NO was negatively correlated with acute vascular occlusion(r =-0.419,P<0.05).Conclusion:Atorvastatin can significantly improve the levels of blood lipid,vWF,NO,E/A and other indicators in patients with unstable angina pectoris with acute vascularocclusion. The clinical effect is satisfactory. Acute vascular occlusion was positively correlated with vWF level and negatively correlated with NO level. The detection of plasma vWF and NO can provide some guidance for the early diagnosis and clinical treatment of unstable angina pectoris.
Objective: To investigate the correlation between acute vascular occlusion and levels of vWF and NO in patients with unstable angina pectoris and the effect of atorvastatin on patients.Methods: 80 patients with UAP with acute vascular occlusion were selected as the subjects. The patients were divided into control group and observation group by random number table grouping method,40 cases in each group.The control group was treated with aspirin,enalapril and isosorbide dinitrate. The observation group was treated with atorvastatin calcium on the basis of the control group. The clinical efficacy,blood lipid levels,vWF,NO and E/A levels were compared between the two groups. Spearman was used to analyze the correlation between acute vascular occlusion and vWF and NO levels.Results: There was no significant difference in the levels of TG,TC,LDL-C,HDL-C,vWF,NO and E/A between the two groups before and after treatment(P>0.05). After treatment,the levels of TG,TC,LDL-C,vWF,E/A were decreased,while the levels of HDL-C and NO were increased in both groups(P<0.05). Group HDL-C and NO levels were higher than those in control group(P<0.05).The total effective rate of the observation group was 87.50%(35/40) significantly higher than that of the control group(67.50%(27/40)(P<0.05); the level of vWF was positively correlated with acute vascular occlusion(r=0.536,P<0.05); the level of NO was negatively correlated with acute vascular occlusion(r =-0.419,P<0.05).Conclusion:Atorvastatin can significantly improve the levels of blood lipid,vWF,NO,E/A and other indicators in patients with unstable angina pectoris with acute vascularocclusion. The clinical effect is satisfactory. Acute vascular occlusion was positively correlated with vWF level and negatively correlated with NO level. The detection of plasma vWF and NO can provide some guidance for the early diagnosis and clinical treatment of unstable angina pectoris.
引文
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[2] Yildiz BS,Murat B,Mustafa Z,et al.Manual thrombus aspiration and the improved survival of patients with unstable angina pectoris treated with percutaneous coronary intervention (30 Months Follow-Up)[J].Medicine,2016,95(8):e2919.
[3] 张洁.瑞舒伐他汀与阿托伐他汀治疗老年不稳定性心绞痛的效果对比研究[J].中外医学研究,2017,15(24):121-122.
[4] Braunwald E,Antman EM,Beasley JW,et al.ACC/AHA guidelines for the management of patients with unstable angina and non-st-segment elevation myocardial infarction:executive summary and recommendations[J].Journal of the American College of Cardiology,2000,40(7):1366-1374.
[5] 廖晓星.慢性稳定型心绞痛诊疗指南(1999 年)——美国心脏病学院(ACC)/美国心脏学会(AHA)/美国医师学院及美国内科学会ACP-ASIM联合议定[J].岭南心血管病杂志,2000,6(3):215-216.
[6] 滕树恩,黄铮,谢晋国,等.不稳定型心绞痛患者择期PCI术后替格瑞洛抗血小板治疗晚期临床疗效及安全性评价[J].中国动脉硬化杂志,2016,24(6):591-594.
[7] 王齐明.绿茶多酚EGCG增强动脉粥样硬化斑块稳定性及其相关机制研究[D].南京医科大学,2017.
[8] 白海燕.综合性护理干预对不稳定型心绞痛患者治疗效果的研究[J].检验医学与临床,2016,13(14):2019-2021.
[9] 王峰,王植荣,陈建业,等.水蛭提取物对冠心病不稳定型心绞痛患者血管内皮功能的影响[J].中西医结合心脑血管病杂志,2013,11(10):1188-1189.
[10] 梁普博,郑云龙,袁月荣.不稳定型心绞痛病人血尿酸水平与血管内皮功能的相关性研究[J].中西医结合心脑血管病杂志,2017,15(16):1993-1996.
[11] 孙勇,韩晓峰,王健.强化剂量阿托伐他汀对不稳定型心绞痛患者介入治疗术后心肌炎症反应的影响[J].现代药物与临床,2014,29(10):1125-1128.