氯吡格雷联合曲美他嗪对冠心病患者脂蛋白a和纤维蛋白原表达的影响

Effects of clopidogrel combined with trimetazidine on LP(a) and Fib expression in patients with coronary heart disease

目的探究氯吡格雷联合曲美他嗪对冠心病患者脂蛋白a[LP(a)]、血浆纤维蛋白原(Fib)表达的影响。方法选取接受冠心病治疗的100例患者,使用完全随机法将患者随机分为对照、观察两个组,各50例。对照组患者在常规治疗的基础上给予曲美他嗪进治疗,观察组患者在对照组患者治疗基础上加用氯吡格雷进行治疗。观察两组患者血脂水平、LP(a)、Fib水平、同型半胱氨酸(Hcy)、血清C反应蛋白(CRP)水平的变化和心电图改善情况,并统计两组患者的治疗效果。结果治疗后,观察组总胆固醇(TC)、三酰甘油(TG)以及低密度脂蛋白胆固醇(LDL-C)水平低于对照组,高密度脂蛋白胆固醇(HDL-C)水平高于对照组(P<0.05)。治疗后,两组患者LP(a)、Fib水平低于治疗前(P<0.05),观察组患者LP(a)、Fib水平低于对照组(P<0.05)。治疗后,两组患者Hcy、CRP水平均低于治疗前(P<0.05),观察组患者Hcy、CRP水平低于对照组(P<0.05)。观察组患者治疗有效率(96.00%)高于对照组患者(88.00%),差异有统计学意义(P<0.05)。观察组患者心电图改善有效率(94.00%)高于对照组(78%),差异有统计学意义(P<0.05)。结论氯吡格雷联合曲美他嗪治疗冠心病患者效果显著,安全可行。

Objective To investigate the effects of clopidogrel combined with trimetazidine on the expression of lipoprotein a[LP(a)],plasma fibrinogen(Fib)in patients with coronary heart disease.Methods A hundred patients with coronary heart disease treated in our hospital from August 2017 to July 2018 were randomly divided into two groups(n=50).The control group was treated with trimetazidine on the basis of routine treatment,while the observation group was treated with clopidogrel on the basis of the control group.The levels of blood lipid,LP(a),Fib,homocysteine(Hcy),serum C-reactive protein(CRP)and electrocardiogram(ECG)of the two groups were observed,and the therapeutic effects of the two groups were analyzed.Results The levels of TC,TG and LDL-C in the observation group were significantly lower than those in the control group;while the level of HDL-C in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the levels of LP(a)and Fib in the two groups were significantlylower than those before treatment(P<0.05),while the levels of LP(a)and Fib in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of Hcy and CRP in the two groups were significantly lower than those before treatment(P<0.05),while those in the observation group were significantly lower than those in the control group(P<0.05).The effective rate of treatment in the observation group was 96.00%,which was significantly higher than that in the control group(88.00%,P<0.05).The effective rate of ECG improvement in the observation group was 94.00%,which was significantly higher than 78%in the control group(P<0.05).Conclusion Clopidogrel combined with trimetazidine is effective,safe and feasible in the treatment of patients with coronary heart disease.