阿托伐他汀联合氯吡格雷治疗不稳定型心绞痛患者的效果及预后

Therapeutic effect of atorvastatin combined clopidogrel on patients with angina pectoris and their prognosis

目的:分析阿托伐他汀联合氯吡格雷治疗不稳定型心绞痛(UAP)患者的效果及对预后的影响。方法:215例UAP患者随机分为阿托伐他汀组(106例,在常规治疗的基础上行阿托伐他汀治疗)与联合治疗组(109例,在常规治疗的基础上给予阿托伐他汀联合氯吡格雷治疗),对比两组治疗效果,血清超敏C反应蛋白(hsCRP)、血脂、白细胞介素6(IL-6)水平等的变化。结果:联合治疗组总有效率明显高于阿托伐他组(94.5%比76.4%,P<0.01)。两组治疗后hsCRP、IL-6、总胆固醇(TC)水平均较治疗前明显降低(P均<0.01);且与阿托伐他汀组比较,联合治疗组hsCRP[(5.35±1.37)mg/L比(3.36±1.25)mg/L]、IL-6[(17.36±4.58)pg/ml比(12.28±3.24)pg/ml]、TC[(7.69±1.20)mmol/L比(4.35±1.20)mmol/L]、TG[(3.35±1.02)mmol/L比(1.29±0.25)mmol/L]水平降低更显著(P均<0.01)。联合治疗组不良心脏事件总发生率明显低于阿托伐他汀组(3.7%比16.0%,P=0.002)。结论:不稳定型心绞痛患者采用阿托伐他汀联合氯吡格雷治疗能显著提高疗效,有效抑制炎症反应,减小不良心脏事件的发生率。

Objective： To analyze therapeutic effect of atorvastatin combined clopidogrel on patients with unstable angina pectoris （UAP） and its influence on prognosis. Methods： A total of 215 UAP patients were randomly divided into atorvastatin group （n = 106, received atorvastatin based on routine treatment） and combined treatment group （n = 109, received atorvastatin combined clopidogrel based on routine treatment）. Therapeutic effect, levels of serum high sensitive C reactive protein （hsCRP）, blood lipids and interleukin （IL） -6 etc. were compared between two groups. Results： Total effective rate of combined treatment group was significantly higher than that of atorvastatin group （94.5% vs. 76.4%, P〈0.01）. Compared with before treatment, there were significant reductions in levels of hsCRP, IL-6 and total cholesterol （TC） in both groups after treatment, P〈0.01 all; compared with atorvastatin group, there were significant reductions in levels of hsCRP [ （5.35 ± 1.37） mg/L vs. （3.36 ± 1.25） mg/L], IL-6 （17.36 ± 4. 58） pg/ml vs. （12.28 ± 3.24） pg/ml], TC [ （7.69 ± 1.20） mmol/L vs. （4.35 ± 1.20） mmol/L] and TG [ （3.35 ± 1.02） rnmol/L vs. （1.29 ± 0.25） mmol/L] in combined treatment group, P〈0.01 all. Total incidence rate of adverse cardiac events in combined treatment group was significantly lower than that of atorvastatin group （3.7% vs. 16.0%, P = 0.002）. Conclusion： Atorvastatin combined clopidogrel cansignificantly enhance therapeutic effect, effectively inhibit inflammation, reduce incidence rate of adverse cardiac events in patients with unstable angina pectoris.