替米沙坦联合瑞舒伐他汀治疗老年冠心病并糖尿病近远期疗效观察

Short-Term and Long-Term Efficacy of Telmisartan Combined with Rosuvastatin in the Treatment of Elderly Coronary Heart Disease Complicated with Diabetes Mellitus

目的 探讨替米沙坦联合瑞舒伐他汀治疗老年冠状动脉粥样硬化性心脏病(CHD)并糖尿病(DM)的近远期疗效。方法 选取中国人民解放军联勤保障部队临潼康复疗养中心2020年1月至2022年1月收治的老年CHD并DM患者120例,按随机数字表法分为观察组和对照组,各60例。两组患者均在常规治疗基础上口服瑞舒伐他汀钙胶囊,每次10 mg,每日1次,观察组患者加服替米沙坦片,每次40 mg,每日1次。两组均以4周为1个疗程,连续治疗4个疗程。治疗后随访1年,观察心血管不良事件发生情况。结果 观察组总有效率为93.33%,明显高于对照组的73.33%(P <0.05)。两组患者治疗后的总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平均明显降低,高密度脂蛋白胆固醇水平均明显升高(P <0.05);左心室舒张末期内径、左心室收缩末期内径明显缩短,而左心室射血分数明显升高(P <0.05);空腹血糖和餐后2 h血糖、糖化血红蛋白水平均明显降低(P <0.05);且观察组均明显优于对照组(P <0.05)。观察组不良反应发生率为13.33%,明显低于对照组的28.33%(P <0.05)。随访1年内,观察组心血管不良事件发生率为15.00%,明显低于对照组的33.33%(P <0.05)。结论 替米沙坦联合瑞舒伐他汀治疗CHD并DM,能有效改善老年患者的血脂和糖代谢水平,调节心功能,减轻心肌缺血情况,预后效果较好。

Objective To investigate the short-term and long-term efficacy of telmisartan combined with rosuvastatin in the treatment of elderly coronary heart disease(CHD)complicated with diabetes mellitus(DM).Methods A total of 120 elderly patients with CHD and DM admitted to the Lintong Rehabilitation Center of the PLA Joint Logistic Support Force from January 2020 to January 2022 were selected and divided into the observation group and the control group by the random number table method,with 60 cases in each group.Both groups were treated with conventional treatment and Rosuvastatin Calcium Capsules orally(once a day,10 mg each time),on this basis,the patients in the observation group were treated with Telmisartan Tablets orally(once a day,40 mg each time).Both groups were treated for four continuous courses,with four weeks as a course.The patients were followed up for one year after treatment to observe the incidence of cardiovascular adverse events.Results The total effective rate in the observation group was 93.33%,which was significantly higher than 73.33%in the control group(P<0.05).After treatment,the total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)levels in the two groups were significantly lower,and the high-density lipoprotein cholesterol(HDL-C)level was significantly higher(P<0.05).After treatment,the left ventricular end-diastolic diameter(LVEDd)and left ventricular end-systolic diameter(LVESd)in the two groups were significantly shorter,while the left ventricular ejection fraction(LVEF)was significantly higher(P<0.05).After treatment,the fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPG)and glycosylated hemoglobin(HbA1C)levels in the two groups were significantly lower(P<0.05).The above indexes in the observation group were significantly better than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 13.33%,which was significantly lower than 28.33%in the control group(P<0.05).During one year of follow-up,the incidence of cardiovascular adverse events in the observation group was 15.00%,which was significantly lower than 33.33%in the control group(P<0.05).Conclusion Telmisartan combined with rosuvastatin in the treatment of elderly CHD complicated with DM is effective,which can improve the blood lipid and glucose metabolism levels,regulate cardiac function,alleviate myocardial ischemia,and the prognosis is good.