不同剂量瑞舒伐他汀联合曲美他嗪治疗不稳定型心绞痛临床效果及对心功能的影响
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摘要
目的探讨不同剂量瑞舒伐他汀联合曲美他嗪治疗不稳定型心绞痛患者的临床效果及对心功能的影响。方法对2015年5月—2017年12月就诊的不稳定型心绞痛患者118例的临床资料进行回顾性分析。根据瑞舒伐他汀剂量分为低剂量组56例和高剂量组62例。低剂量组每晚予以10 mg瑞舒伐他汀口服,高剂量组每晚予以20 mg瑞舒伐他汀口服,均治疗3个月。治疗结束后比较2组血清同型半胱氨酸(Hcy)、C-反应蛋白(CRP)和血浆内皮素(ET)水平及心功能和临床疗效,并记录2组不良反应的发生情况。结果 2组治疗后Hcy、CRP和ET水平均较治疗前下降,且高剂量组低于低剂量组(P<0.05,P<0.01)。2组患者治疗后心功能均较治疗前改善,高剂量组改善程度优于低剂量组(P<0.05,P<0.01)。高剂量组总有效率高于低剂量组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论高剂量瑞舒伐他汀联合曲美他嗪治疗不稳定型心绞痛患者更有利于改善心功能和提高其临床疗效,且具有一定的安全性。
Objective To investigate clinical efficacy and effects on cardiac function of different doses of Rosuvastatin combined with Trimetazidine in treatment of patients with unstable angina pectoris. Methods Clinical data of 118 patients with unstable angina pectoris admitted during May 2015 and December 2017 was retrospectively analyzed, and the patients were divided into low-dose group(n=56) and high-dose group(n=62) according to Rosuvastatain doses. Low-dose group was treated with 10 mg Rosuvastatin orally every night, while high-dose group was treated with 20 mg Rosuvastatin orally every night. Patients in both groups were treated for 3 months. After treatment, levels of serum homocysteine(Hcy), c-reactive protein(CRP) and plasma endothelin(ET), cardiac function and clinical efficacy were compared, and incidence rate of adverse reactions were recorded in two groups. Results After treatment, levels of Hcy, CRP and ET were significantly lower than those before treatment in two groups, but the levels in high-dose group were significantly lower than those in low-dose group(P<0.05, P<0.01); conditions of cardiac function were significantly improved after treatment than those before treatment in two groups, and the improved condition in high-dose group was significantly better than that in low-dose group(P<0.05, P<0.01). The total effective rate in high-dose group was significantly higher than that in low-dose group(P<0.05). There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05). Conclusion High-dose Rosuvastatin combined with Trimetazidine in treatment of patients with unstable angina pectoris is more beneficial to improve cardiac function and clinical efficacy with a certain safety.
Objective To investigate clinical efficacy and effects on cardiac function of different doses of Rosuvastatin combined with Trimetazidine in treatment of patients with unstable angina pectoris. Methods Clinical data of 118 patients with unstable angina pectoris admitted during May 2015 and December 2017 was retrospectively analyzed, and the patients were divided into low-dose group(n=56) and high-dose group(n=62) according to Rosuvastatain doses. Low-dose group was treated with 10 mg Rosuvastatin orally every night, while high-dose group was treated with 20 mg Rosuvastatin orally every night. Patients in both groups were treated for 3 months. After treatment, levels of serum homocysteine(Hcy), c-reactive protein(CRP) and plasma endothelin(ET), cardiac function and clinical efficacy were compared, and incidence rate of adverse reactions were recorded in two groups. Results After treatment, levels of Hcy, CRP and ET were significantly lower than those before treatment in two groups, but the levels in high-dose group were significantly lower than those in low-dose group(P<0.05, P<0.01); conditions of cardiac function were significantly improved after treatment than those before treatment in two groups, and the improved condition in high-dose group was significantly better than that in low-dose group(P<0.05, P<0.01). The total effective rate in high-dose group was significantly higher than that in low-dose group(P<0.05). There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05). Conclusion High-dose Rosuvastatin combined with Trimetazidine in treatment of patients with unstable angina pectoris is more beneficial to improve cardiac function and clinical efficacy with a certain safety.
引文
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[2] 杨召伍,陈泽江,钟江华,等.瑞舒伐他汀联合曲美他嗪治疗急性心肌梗死后心绞痛的临床疗效及其对血脂和血液流变学的影响[J].实用心脑肺血管病杂志,2016,24(1):58-60.
[3] 贺文婷,秦越.曲美他嗪联合瑞舒伐他汀对急性冠脉综合征患者血清炎性因子和左心舒张功能的影响[J].陕西医学杂志,2016,45(11):1522-1523.
[4] 夏胜勇.不同剂量瑞舒伐他汀联合曲美他嗪治疗老年冠心病左心功能不全的疗效观察[J].老年医学与保健,2017,23(4):339-340,348.
[5] 高秋,杨松,陈燕春,等.经皮冠状动脉介入治疗不稳定型心绞痛应用阿托伐他汀联合曲美他嗪对炎性因子的影响[J].河北医药,2016,38(21):3227-3229,3233.
[6] 杨红娟.银杏达莫注射液对不稳定型心绞痛的疗效观察[J].解放军医药杂志,2017,29(11):65-68.
[7] 廖雪松.不同剂量辛伐他汀联合曲美他嗪对慢性心力衰竭患者血清hs-CRP及心功能分级的影响[J].河北医药,2016,38(2):215-217.
[8] 叶廖沙,石宇杰,李俊峡,等.不同剂量瑞舒伐他汀钙治疗冠状动脉慢血流的临床效果研究[J].临床误诊误治,2015,28(1):91-94.
[9] Betto M,Fares J,Saliba N,et al.Efficacy and safety of a generic rosuvastatin in a real-world setting:prospective,observational clinical study in Lebanese patients[J].Ann Saudi Med,2017,37(5):366-374.
[10] 丹参多酚酸盐与辛伐他汀治疗老年不稳定心绞痛临床疗效比较[J].西部医学,2015,27(3):352-355.
[11] 裴东果,刘德敏,杨晓红,等.以心绞痛为主要表现的右心房黏液瘤误诊报告并文献复习[J].临床误诊误治,2017,30(4):57-59.
[12] 陈亚静,陈亚青,肖暖,等.冠心舒通胶囊联合盐酸曲美他嗪对不稳定型心绞痛病人IL-6、NT-proBNP的影响[J].中西医结合心脑血管病杂志,2016,14(21):2484-2486.
[13] 莫晓东,唐艺加,龙恩武.阿托伐他汀强化降脂治疗对不稳定型心绞痛患者血脂、炎性细胞因子及心功能的影响[J].解放军医药杂志,2017,29(7):70-73.
[14] 朱苑芳,王军.曲美他嗪治疗稳定型心绞痛临床疗效观察[J].心脑血管病防治,2016,16(1):40-42.
[15] 潘兴飞,张绍全,黄小萍,等.白细胞介素32γ通过活化核转录因子κB通路诱导LX-2细胞表达基质金属蛋白酶9[J].医学分子生物学杂志,2016,13(3):149-152.
[16] 林波.优质护理服务在冠心病患者PCI术围手术期的应用[J].保健医学研究与实践,2017,14(1):77-79.
[17] Farnier M,Jones P,Severance R,et al.Efficacy and safety of adding alirocumab to rosuvastatin versus adding ezetimibe or doubling the rosuvastatin dose in high cardiovascular-risk patients:the ODYSSEY OPTIONS Ⅱ randomized trial[J].Atherosclerosis,2016,244:138-146.
[18] 曾振宇,易启兰,陈建辉,等.银杏达莫治疗冠心病不稳定性心绞痛的疗效及其对内皮细胞功能的影响[J].西部医学,2016,28(3):361-364.
[19] 李翠萍.非ST段抬高型急性心肌梗死临床特点分析[J].临床误诊误治,2015,28(11):65-68.
[20] 卜伟.曲美他嗪联合阿托伐他汀对稳定型心绞痛病人SOD和MDA的影响[J].中西医结合心脑血管病杂志,2017,15(20):2578-2580.
[21] 陈慧敏,许逸飞.曲美他嗪联合阿托伐他汀钙治疗冠心病心绞痛伴血脂异常的临床研究[J].中国临床药理学杂志,2016,32(11):966-968.
[22] 程远大,张春芳,高阳.miRNA-1靶基因的生物信息学分析[J].医学分子生物学杂志,2016,13(4):193-197.
[23] 翟东东,韩雅蕾,王蕾,等.双倍剂量与标准剂量曲美他嗪对不稳定型心绞痛行经皮冠状动脉介入治疗患者围术期心肌保护作用的对比研究[J].中国介入心脏病学杂志,2017,25(2):77-81.
[24] Stein E A,Dann E J,Wiegman A,et al.Efficacy of rosuvastatin in children with homozygous familial hypercholesterolemia and association with underlying genetic mutations[J].J Am Coll Cardiol,2017,70(9):1162-1170.
[25] 黄守莲.阿托伐他汀联合曲美他嗪在冠心病患者的多靶点治疗效果分析[J].陕西医学杂志,2016,45(12):1669-1670.
[2] 杨召伍,陈泽江,钟江华,等.瑞舒伐他汀联合曲美他嗪治疗急性心肌梗死后心绞痛的临床疗效及其对血脂和血液流变学的影响[J].实用心脑肺血管病杂志,2016,24(1):58-60.
[3] 贺文婷,秦越.曲美他嗪联合瑞舒伐他汀对急性冠脉综合征患者血清炎性因子和左心舒张功能的影响[J].陕西医学杂志,2016,45(11):1522-1523.
[4] 夏胜勇.不同剂量瑞舒伐他汀联合曲美他嗪治疗老年冠心病左心功能不全的疗效观察[J].老年医学与保健,2017,23(4):339-340,348.
[5] 高秋,杨松,陈燕春,等.经皮冠状动脉介入治疗不稳定型心绞痛应用阿托伐他汀联合曲美他嗪对炎性因子的影响[J].河北医药,2016,38(21):3227-3229,3233.
[6] 杨红娟.银杏达莫注射液对不稳定型心绞痛的疗效观察[J].解放军医药杂志,2017,29(11):65-68.
[7] 廖雪松.不同剂量辛伐他汀联合曲美他嗪对慢性心力衰竭患者血清hs-CRP及心功能分级的影响[J].河北医药,2016,38(2):215-217.
[8] 叶廖沙,石宇杰,李俊峡,等.不同剂量瑞舒伐他汀钙治疗冠状动脉慢血流的临床效果研究[J].临床误诊误治,2015,28(1):91-94.
[9] Betto M,Fares J,Saliba N,et al.Efficacy and safety of a generic rosuvastatin in a real-world setting:prospective,observational clinical study in Lebanese patients[J].Ann Saudi Med,2017,37(5):366-374.
[10] 丹参多酚酸盐与辛伐他汀治疗老年不稳定心绞痛临床疗效比较[J].西部医学,2015,27(3):352-355.
[11] 裴东果,刘德敏,杨晓红,等.以心绞痛为主要表现的右心房黏液瘤误诊报告并文献复习[J].临床误诊误治,2017,30(4):57-59.
[12] 陈亚静,陈亚青,肖暖,等.冠心舒通胶囊联合盐酸曲美他嗪对不稳定型心绞痛病人IL-6、NT-proBNP的影响[J].中西医结合心脑血管病杂志,2016,14(21):2484-2486.
[13] 莫晓东,唐艺加,龙恩武.阿托伐他汀强化降脂治疗对不稳定型心绞痛患者血脂、炎性细胞因子及心功能的影响[J].解放军医药杂志,2017,29(7):70-73.
[14] 朱苑芳,王军.曲美他嗪治疗稳定型心绞痛临床疗效观察[J].心脑血管病防治,2016,16(1):40-42.
[15] 潘兴飞,张绍全,黄小萍,等.白细胞介素32γ通过活化核转录因子κB通路诱导LX-2细胞表达基质金属蛋白酶9[J].医学分子生物学杂志,2016,13(3):149-152.
[16] 林波.优质护理服务在冠心病患者PCI术围手术期的应用[J].保健医学研究与实践,2017,14(1):77-79.
[17] Farnier M,Jones P,Severance R,et al.Efficacy and safety of adding alirocumab to rosuvastatin versus adding ezetimibe or doubling the rosuvastatin dose in high cardiovascular-risk patients:the ODYSSEY OPTIONS Ⅱ randomized trial[J].Atherosclerosis,2016,244:138-146.
[18] 曾振宇,易启兰,陈建辉,等.银杏达莫治疗冠心病不稳定性心绞痛的疗效及其对内皮细胞功能的影响[J].西部医学,2016,28(3):361-364.
[19] 李翠萍.非ST段抬高型急性心肌梗死临床特点分析[J].临床误诊误治,2015,28(11):65-68.
[20] 卜伟.曲美他嗪联合阿托伐他汀对稳定型心绞痛病人SOD和MDA的影响[J].中西医结合心脑血管病杂志,2017,15(20):2578-2580.
[21] 陈慧敏,许逸飞.曲美他嗪联合阿托伐他汀钙治疗冠心病心绞痛伴血脂异常的临床研究[J].中国临床药理学杂志,2016,32(11):966-968.
[22] 程远大,张春芳,高阳.miRNA-1靶基因的生物信息学分析[J].医学分子生物学杂志,2016,13(4):193-197.
[23] 翟东东,韩雅蕾,王蕾,等.双倍剂量与标准剂量曲美他嗪对不稳定型心绞痛行经皮冠状动脉介入治疗患者围术期心肌保护作用的对比研究[J].中国介入心脏病学杂志,2017,25(2):77-81.
[24] Stein E A,Dann E J,Wiegman A,et al.Efficacy of rosuvastatin in children with homozygous familial hypercholesterolemia and association with underlying genetic mutations[J].J Am Coll Cardiol,2017,70(9):1162-1170.
[25] 黄守莲.阿托伐他汀联合曲美他嗪在冠心病患者的多靶点治疗效果分析[J].陕西医学杂志,2016,45(12):1669-1670.