曲美他嗪联合阿托伐他汀治疗不稳定型心绞痛的临床疗效分析

Clinical Research of Trimetazidine Combined with Atorvastatin in Treatment of Unstable Angina

目的探讨曲美他嗪联合阿托伐他汀治疗不稳定型心绞痛的临床疗效。方法选取海军总医院2011年1月—2012年6月不稳定型心绞痛患者122例,随机分为两组,61例患者行常规治疗为对照组,61例患者同时给予曲美他嗪、阿托伐他汀治疗为观察组,随访6个月,比较两组患者的临床指征、临床疗效、并发症情况、再住院情况。结果治疗后,观察组与对照组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、C反应蛋白(CRP)均显著降低,观察组与对照组高密度脂蛋白胆固醇(HDL-C)显著升高。观察组TC、TG、LDL-C、CRP均明显低于对照组,观察组HDL-C均明显高于对照组,观察组心绞痛总有效率95.1%、心电图总有效率83.6%,均明显高于对照组的80.3%、60.7%,观察组再住院率明显低于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率高于对照组,差异无统计学意义(P>0.05)。曲美他嗪联合阿托伐他汀治疗与硝酸盐、β受体阻滞剂、钙拮抗剂等用药治疗存在明显正相关性。结论曲美他嗪联合阿托伐他汀治疗不稳定型心绞痛的临床疗效显著,可明显改善患者的临床指标和临床病症,降低再住院率,值得临床推广使用。

Objective To investigate the clinical effect of trimetazidine combined with atorvastatin in treatment of unstable angina. Methods 122 patients with unstable angina were selected in our hospital between January 2011 and June 2012, who were randomly divided into two groups. 61 patients received a conventional therapy as control group, while the other half were treated with trimetazidine and atorvastatin at the same time as observation group. Patients were followed up for 6 months. Indications, clinical effect, complications and readmission were compared between the two groups. Results After treatment, total cholesterol, triglyceride, low density lipoprotein cholesterol, C reactive protein in both groups decreased significantly,while high density lipoprotein cholesterol increased significantly. Total cholesterol, triglyceride, low density lipoprotein cholesterol, C reactive protein in observation group were significantly lower than in control group,but high density lipoprotein cholesterol was significantly higher,total effective rates of angina （95.1% ） and ECG（83.6% ） in observation group were significantly higher than in control group（80.3% ,60.7% ） ,but the readmission rate was significantly lower. The difference was statistically significant（ P 〈0.05）. The rate of complications in observa-tion group was higher than in control group, but the difference was not statistically significant （ P 〉 0.05 ）. Treatment with trimetazidine combined with atorvastatin had significant positive correlation with nitrates,beta blockers,calcium an-tagonists and other drugs. Conclusion The clinical effect of trimetazidine combined with atorvastatin in treatment of un-stable angina is remarkable ,which can significantly improve clinical indicators and symptoms.