阿托伐他汀联合艾司洛尔对冠心病心绞痛患者血脂代谢和血液流变学的影响分析

Effect analysis of atorvastatin combined with esmolol on blood lipid metabolism and hemorheology in patients with angina pectoris of coronary heart disease

目的 观察对冠心病心绞痛患者应用阿托伐他汀联合艾司洛尔治疗的效果。方法 86例冠心病心绞痛患者,根据抽签法分成对照组和观察组,每组43例。对照组给予阿托伐他汀进行治疗,观察组在对照组基础上加用艾司洛尔进行治疗。比较两组治疗前后临床症状积分、血脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、血液流变学指标(全血低切粘度、血浆粘度以及纤维蛋白原)、心功能指标(心输出量、每搏输出量、左心室短轴缩短率、左心室射血分数)以及生存质量。结果 治疗后,观察组胸区疼痛、心慌、心悸、胸闷、呼吸困难积分分别为(1.23±0.45)、(1.18±0.54)、(1.56±0.82)、(1.38±0.52)、(1.07±0.31)分,低于对照组的(2.57±0.79)、(2.68±0.93)、(2.37±0.92)、(2.45±0.62)、(2.05±0.46)分(P<0.05)。治疗后,观察组TC(4.37±0.82)mmol/L、TG(1.75±0.30)mmol/L、LDL-C(2.45±0.24)mmol/L低于对照组的(5.56±1.19)、(2.96±0.33)、(3.16±0.20)mmol/L, HDL-C(1.51±0.15)mmol/L高于对照组的(1.26±0.22)mmol/L(P<0.05)。治疗后,观察组全血低切粘度、血浆粘度以及纤维蛋白原水平分别为(7.94±0.80)mPa·s、(5.60±1.17)mPa·s、(4.25±0.46)g/L,低于对照组的(9.83±1.06)mPa·s、(6.78±1.32)mPa·s、(4.72±0.12)g/L(P<0.05)。治疗后,观察组每搏输出量(53.91±3.40)ml、心输出量(4.22±0.61)L/min、左心室短轴缩短率(26.01±3.65)%、左心室射血分数(50.89±2.62)%均高于对照组的(49.56±3.78)ml、(3.59±0.50)L/min、(24.38±2.70)%、(45.71±2.20)%(P<0.05)。与对照组治疗后比较,观察组治疗后身体功能、疼痛、睡眠、社会孤立状况、情绪反应及活力水平评分均更低(P<0.05)。结论 阿托伐他汀联合艾司洛尔治疗冠心病心绞痛的疗效佳,患者临床症状、血脂代谢、血液流变学均改善,心功能、生存质量得以提升,值得应用。

Objective To observe the effect of atorvastatin combined with esmolol on blood lipid metabolism and hemorheology in patients with angina pectoris.Methods 86 patients with angina pectoris of coronary heart disease were divided into a control group and an observation group according to lottery method,with 43 cases in each group.The control group was treated with atorvastatin,and the observation group was treated with esmolol on the basis of the control group.Both groups were compared in terms of clinical symptom score,lipid metabolism indexes[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)],hemorheology indexes(whole blood low shear viscosity,plasma viscosity and fibrinogen),cardiac function indexes(cardiac output,stroke output,left ventricular fraction shortening,left ventricular ejection fraction),and quality of life before and after treatment.Results After treatment,the scores of chest pain,panic,palpitation,chest tightness and dyspnea in the observation group were(1.23±0.45),(1.18±0.54),(1.56±0.82),(1.38±0.52)and(1.07±0.31)points,which were lower than(2.57±0.79),(2.68±0.93),(2.37±0.92),(2.45±0.62)and(2.05±0.46)points in the control group(P<0.05).After treatment,the observation group had TC of(4.37±0.82)mmol/L,TG of(1.75±0.30)mmol/L and LDL-C of(2.45±0.24)mmol/L,which were lower than(5.56±1.19),(2.96±0.33)and(3.16±0.20)mmol/L in the control group;the observation group had higher HDL-C of(1.51±0.15)mmol/L than(1.26±0.22)mmol/L in the control group(P<0.05).After treatment,the whole blood low shear viscosity,plasma viscosity and fibrinogen level in the observation group were(7.94±0.80)mPa·s,(5.60±1.17)mPa·s and(4.25±0.46)g/L,which were lower than(9.83±1.06)mPa·s,(6.78±1.32)mPa·s and(4.72±0.12)g/L in the control group(P<0.05).After treatment,the observation group had stroke output of(53.91±3.40)ml,cardiac output of(4.22±0.61)L/min,left ventricular fraction shortening of(26.01±3.65)%and left ventricular ejection fraction of(50.89±2.62)%,which were higher than(49.56±3.78)ml,(3.59±0.50)L/min,(24.38±2.70)%and(45.71±2.20)%in the control group(P<0.05).Compared with the control group,the scores of physical function,pain,sleep,social isolation,emotional response and vitality level were lower in the observation group after treatment(P<0.05).Conclusion The efficacy of atorvastatin combined with esmolol in the treatment of angina pectoris of coronary artery disease is good,and patients'clinical symptoms,lipid metabolism,and hemorheology are all improved,and cardiac function and quality of survival can be improved,which is worthy of application.