不同剂量阿托伐他汀钙片联合阿司匹林肠溶片对糖尿病患者动脉粥样硬化斑块稳定性影响的对比分析

Comparative analysis of the effects of different doses of atorvastatin tablets combined with aspirin enteric-coated tablets on the stability of diabetic atherosclerotic plaque

目的:探讨不同剂量阿托伐他汀钙片联合阿司匹林肠溶片治疗糖尿病患者动脉粥样硬化斑块稳定性的影响。方法:将300例糖尿病合并冠心病患者均分为两组,对照组采用标准剂量阿托伐他汀钙片联合阿司匹林肠溶片进行治疗,观察组则将阿托伐他汀钙片使用剂量进行加倍。对比两组治疗前后空腹血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、血肌酐(Scr)水平及谷丙转氨酶(ALT)水平;测定记录两组治疗前后冠状动脉腔内钙化型、中间型、软斑块及总斑块数目、颈动脉内膜中层厚度(CIMT);分析两组临床效果及不良反应发生率。结果:经治疗,两组HDL-C含量明显增加,LDL-C、TG、TC含量均明显较少(P<0.05);血清Scr、ALT水平略升高,但差异无统计学意义(P>0.05);钙化斑块数目增加,而中间型、软化型及总斑块数目明显减少,CIMT明显缩小(P<0.05)。与对照组比,观察组HDL-C含量增加及LDL-C、TG、TC含量减少更明显(P<0.05);钙化斑块数目增加更明显,中间型斑块、软化型斑块、总斑块数目减少,CIMT缩小,临床总有效率明显升高(P<0.05),但Scr、ALT水平升高并不明显,且两组不良反应发生率相当(P>0.05)。结论:加倍剂量阿托伐他汀钙片联合阿司匹林肠溶片治疗糖尿病合并冠心病具有更好的抗动脉粥样硬化、稳定硬化斑块的作用,且安全性高。

Objective:To investigate the clinical effects of different doses of atorvastatin tablets combined with aspirin in the treatment of diabetic coronary heart disease and its effect on the stability of atherosclerotic plaque.Methods:300patients with diabetes mellitus and coronary heart disease were divided into two groups.The control group was treated with standard doses of atorvastatin tablets in combination with aspirin.The observation group was treated with a2-fold dose of atorvastatin.The levers of HDL-C,LDL-C,TG,TC,Scr and alanine aminotransferase(ALT)levels were compared before and after treatment.The number of coronary calcifications,intermediate,soft plaques,total plaques and the value of CIMTbefore and after treatment were recorded.The clinical effects and incidence of adverse reactions were analyzed.Results:After treatment and treatment,the HDL-C content of the two groups increased significantly,and the contents of LDL-C,TG and TC were significantly less(P<0.05),Serum Scr and ALT levels were slightly elevated,but the difference was not statistically significant(P>0.05),the number of calcified plaques increased in the two groups,while the number of intermediate,softening and total plaques decreased significantly,and CIMT decreased significantly(P<0.05).Compared with the control group,the increase of HDL-C content and the decrease of LDL-C,TG and TC content in the observation group were more significant(P<0.05),the number of calcified plaques increased more significantly,the intermediate type,softening type,total plaques,CIMT decreased significantly,and the total clinical effective rate increased significantly(P<0.05),but the increase of Scr and ALT levels was not obvious,and the incidence of adverse reactions was equivalent between two groups(P>0.05).Conclusion:Double-dose atorvastatin combined with aspirin enteric treatment for diabetic coronary heart disease has better anti-atherosclerosis,stable and hardened plaque stability,and is safe.