阿托伐他汀钙联合硫酸氢氯吡格雷对冠状动脉病变的影响分析

Analysis of the effects of atorvastatin and clopidogrel on coronary artery disease

目的探讨阿托伐他汀钙联合硫酸氢氯吡格雷对冠状动脉病变的影响。方法 2013年8月—2017年1月选择在南通市肿瘤医院诊治的急性冠状动脉综合征患者122例,根据随机信封抽签原则平均分为观察组与对照组各61例,两组都给予经皮冠状动脉介入治疗,对照组给予硫酸氢氯吡格雷辅助治疗,观察组给予阿托伐他汀钙联合硫酸氢氯吡格雷辅助治疗,都治疗观察4周。比较两组临床疗效,在治疗前后采用超声测量左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)变化,采用免疫荧光标记法测定血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)。结果观察组的治疗总有效率为96.7%,对照组为82.0%,观察组的总有效率明显高于对照组,差异有统计学意义(P<0.05)。观察组与对照组治疗后的左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)值都明显低于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);同时治疗后观察组的LVEDD和LVESD值也明显低于对照组,差异有统计学意义(P<0.05)。观察组与对照组治疗后的GPⅡb/Ⅲa值分别为(10.22±3.12)%和(14.32±2.98)%,都明显低于治疗前的(20.98±3.30)%和(21.22±2.98)%,差异有统计学意义(P<0.05);观察组也明显低于对照组,差异有统计学意义(P<0.05)。所有患者随访6个月,观察组的心律失常、出血与死亡等发生率为3.3%,对照组为19.7%,观察组明显少于对照组,差异有统计学意义(P<0.05)。结论阿托伐他汀钙和硫酸氢氯吡格雷在急性冠状动脉综合征治疗中的应用能提高心功能,降低GPⅡb/Ⅲa的表达,从而提高近期与远期疗效。

Objective To investigate the effects of atorvastatin and clopidogrel on coronary artery disease. Methods From August 2013 to January 2017, 122 patients of acute coronary syndrome in our hospital for diagnosis and treatment were selected as the research object, all the patients were divided into observation group and control group of 61 case accorded to the random lottery envelopes randomly, two groups were treated with percutaneous coronary artery interventional therapy, the control group was given clopidogrel bisulfate adjuvant therapy, the observation group was given atorvastatin atorvastatin calcium and clopidogrel adjuvant therapy, all patients were observed for 4 weeks. Results The total effective rate of the observation group was significantly higher than that of the control group（P〈0.05）. The LVEDD and LVESD values of the observation group and the control group after treatment were significantly lower than those before treatment（P〈0.05）, while the LVEDD and LVESD values in the observation group were significantly lower than those in the control group（P〈0.05）. The platelet membrane glycoprotein GP IIb/Ⅲa values in the observation group and the control group after treatment were（10.22 ± 3.12）% and（14.32 ± 2.98）% that were significantly lower than those before treatment of（20.98 ± 3.30）% and（21.22 ± 2.98）%, the observation group was significantly lower than the control group（P〈0.05）. All patients were followed up for 6 months, the incidence of arrhythmia, bleeding and death in the observation group was 3.3%, so that was 19.7% in the control group, and the observation group was less than that of the control group（P〈0.05）. Conclusion Atorvastatin atorvastatin calcium and clopidogrel adjuvant in patients with acute coronary syndrome therapy can improve heart function, reduce the expression of platelet membrane glycoprotein GP IIb/IIIa, so as to improve the short-term and long-term efficacy.