高压氧联合阿托伐他汀治疗冠心病患者的临床疗效及对血液流变学指标的影响

Clinical efficacy of hyperbaric oxygen combined with atorvastatin on patients with coronary heart disease and its effects on hemorheological indexes

目的探讨高压氧(HBO)联合阿托伐他汀对冠心病患者的临床疗效及血液流变学指标的影响。方法回顾性分析2016年12月至2018年12月在临沂市中心医院心内科治疗的冠心病患者150例,按照数字表法随机分为联合组和对照组,每组75例。对照组患者在常规治疗的基础上给予阿托伐他汀治疗,联合组患者在对照组治疗的基础上予以HBO治疗。比较2组患者治疗前后的临床疗效、血管炎性因子、D-二聚体及血液流变学指标的变化。结果联合组患者治疗后临床总有效率(93.33%)明显高于对照组(82.67%),差异有统计学意义(χ^2=4.040,P<0.05)。治疗4个疗程后,2组患者血清高敏C反应蛋白(hs-CRP)、脂蛋白相关磷脂酶A2(Lp-PLA2)、低密度脂蛋白(LDL-C)、D-二聚体水平均较治疗前明显降低,且联合组患者治疗后均明显低于对照组,差异均有统计学意义(P<0.05)。2组患者全血高、低、中切黏度,以及血浆黏度和纤维蛋白原(Fib)均明显低于治疗前,且联合组患者治疗后均明显低于对照组,差异均有统计学意义(P<0.05)。结论HBO联合阿托伐他汀治疗冠心病临床效果显著,可明显减轻血管炎性反应,改善血流动力学指标。

Objective To analyze the clinical efficacy of hyperbaric oxygen(HBO)combined with atorvastatin on patients with coronary heart disease and its effects on the changes of hemorheological indexes.Methods A total of 150 patients with coronary heart disease admitted to the Department of Cardiology of Linyi Central Hospital from December 2016 to December 2018 were included into a retrospective analysis,who were randomly divided into the combination group and the control group,with 75 cases each.The control group was treated with atorvastatin on the basis of routine treatment,and the combination group was treated with HBO on the basis of the control group.The clinical efficacy and adverse reactions of the two groups were compared after the treatment,and the changes of vascular inflammatory factors,D-dimer,and hemorheological indexes were compared before and after treatment.Results After HBO combined with atorvastatin treatment,the total clinical effective rate of the combination group was 93.33%,which was significantly higher than that of the control group(82.67%)(χ^2=4.040,P<0.05);after 4 courses of treatment,the levels of hs-CRP,Lp-PLA2,LDL-C,and D-dimer in the two groups were significantly lower than those before treatment(P<0.05),and those in the combination group were significantly lower than those in the control group(P<0.05);after the treatment,the hemorheological indexes,i.e.whole blood high shear viscosity,whole blood middle shear viscosity,whole blood low shear viscosity,plasma viscosity,and fibrinogen,in the two groups were statistically significant lower than those before treatment(P<0.05),and those in the combination group were significantly lower than those in the control group(P<0.05).Conclusion HBO combined with atorvastatin has a significant clinical effect in the treatment of coronary heart disease,which can significantly reduce the inflammatory reaction of blood vessels,and improve the hemorheological indexes.