硫酸氢氯吡格雷片联合阿托伐他汀钙对冠心病PCI术后心绞痛患者血清血脂水平、sCD40L及sICAM-1水平的影响

The Effects of Clopidogrel Hydrogen Sulphate Tablets Combined with Atorvastatin Calcium on Levels of Serum Lipids,sCD40L and sICAM-1 in Patients with Angina Pectoris After PCI for Coronary Heart Disease

目的探讨硫酸氢氯吡格雷片联合阿托伐他汀钙对冠心病冠脉内介入(PCI)术后心绞痛患者血清血脂水平、可溶性CD40L(sCD40L)及可溶性细胞间黏附分子-1(sICAM-1)水平的影响。方法以112例冠心病PCI术后心绞痛患者为研究对象,采用随机数字表法分为对照组和观察组,各56例,对照组采用硫酸氢氯吡格雷片治疗,观察组采用硫酸氢氯吡格雷片联合阿托伐他汀钙治疗,观察治疗前后两组血脂[甘油三酯(TG)、血清总胆固醇(TC)、低密度脂蛋白(LDLC)、高密度脂蛋白(HDLC)]水平、sCD40L、sICAM-1水平,比较两组临床疗效、预后[简明健康状况调查表(SF-36)评分]及药物安全性。结果治疗后两组TG、TC、LDLC、sCD40L、sICAM-1明显降低,HDLC、SF-36评分明显升高,且治疗后观察组各项指标变化较对照组明显,差异有统计学意义(P<0.05);两组不良反应总发生率(12.50%vs8.93%)相较差异无统计学意义(χ^2=0.373,P>0.05)。结论硫酸氢氯吡格雷片联合阿托伐他汀钙治疗冠心病PCI术后心绞痛患者,在调节患者机体血脂水平、sCD40L及sICAM-1水平和临床疗效、改善预后方面有一定积极作用。

Objective To explore the effects of clopidogrel hydrogen sulphate tablets combined with atorvastatin calcium on the levels of serum lipids,soluble CD40L(sCD40L)and soluble intercellular adhesion molecule-1(sICAM-1)in patients with angina pectoris after percutaneous coronary intervention(PCI)for coronary artery disease.Methods 112 cases of patients with angina pectoris after PCI for coronary heart disease were selected for the study.These patients were randomly divided into the control group and the observation group according to the random number table method,with 56 cases in each group.The control group was treated with clopidogrel hydrogen sulphate tablets,and the observation group was given clopidogrel hydrogen sulfate tablets combined with atorvastatin calcium.The levels of blood lipids [triglyceride(TG),serum total cholesterol(TC),low density lipoprotein cholesterol(LDLC),high-density lipoprotein cholesterol(HDLC)] and sCD40L and sICAM-1 were measured before and after the treatment in the two groups,and the clinical efficacy,prognosis [36-item shot-form health status survey(SF-36)score] and drug safety were compared between the two groups.Results After the treatment,the TG,TC,LDLC,sCD40L and sICAM-1 in the two groups were significantly decreased,while the HDLC and SF-36 scores were significantly increased,and the changes of the indexes in the observation group were greater compared with the control group( P < 0.05 ).There was no significant difference in the total incidence rate of adverse reactions between the two groups(12.50%vs8.93%)(χ^2=0.373,P >0.05).Conclusion Clopidogrel hydrogen sulfate tablets combined with atorvastatin calcium for patients with angina pectoris after PCI for coronary heart disease has a positive effect on regulating the levels of blood lipids,sCD40L and sICAM-1,as well as the clinical efficacy,suggesting an improvement of the prognosis.