不同剂量阿托伐他汀钙结合阿司匹林在老年冠心病不稳定型心绞痛患者中的效果及对炎性因子水平的影响分析

Effects of different doses of atorvastatin calcium combined with aspirin for elderly patients with unstable angina pectoris of coronary heart disease and its influence on the levels of inflammatory factors

目的分析老年冠心病不稳定型心绞痛患者开展阿司匹林结合不同剂量阿托伐他汀钙治疗的效果及对患者炎性因子水平的影响。方法100例老年冠心病不稳定型心绞痛患者作为研究对象,均实施阿托伐他汀钙结合阿司匹林治疗,依据阿托伐他汀钙剂量不同分为对照组和观察组,各50例。对照组予以10 mg阿托伐他汀钙治疗,观察组予以20 mg阿托伐他汀钙治疗。比较两组炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-4(IL-4)],血脂指标[高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)],心功能指标[心输出量(CO)、心搏出量(SV)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)],治疗效果,不良反应发生情况。结果治疗后,观察组CRP(6.06±2.06)mg/L、TNF-α(1.33±0.37)ng/ml、IL-6(117.26±26.52)pg/ml低于对照组的(10.11±2.43)mg/L、(1.89±0.41)ng/ml、(141.52±29.33)pg/ml,IL-4(2.53±0.12)pg/ml高于对照组的(1.99±0.23)pg/ml,比较具有统计学意义(P<0.05)。治疗后,观察组HDL-C(1.36±0.36)mmol/L高于对照组的(1.01±0.33)mmol/L,TC(3.83±0.87)mmol/L、TG(1.88±0.52)mmol/L、LDL-C(2.49±0.66)mmol/L低于对照组的(4.59±1.41)、(2.52±0.75)、(3.01±0.81)mmol/L,比较具有统计学意义(P<0.05)。治疗后,观察组CO(5.72±1.11)L/min、SV(72.82±9.77)ml、LVEF(61.02±8.39)%高于对照组的(5.09±0.32)L/min、(64.51±8.03)ml、(56.32±7.27)%,LVEDD(51.33±0.45)mm小于对照组的(51.83±0.57)mm,比较具有统计学意义(P<0.05)。观察组总有效率98.00%高于对照组的86.00%,比较具有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,比较具有统计学意义(P<0.05)。结论针对老年冠心病不稳定型心绞痛患者开展阿托伐他汀钙结合阿司匹林治疗,相较低剂量(10 mg)的阿托伐他汀钙,采用高剂量(20 mg)的阿托伐他汀钙治疗更具优势,有助于改善患者的炎性反应和血脂水平,调节心功能,提高治疗效果且更具安全性,价值显著。

Objective To analyze the effects of aspirin combined with different doses of atorvastatin calcium for elderly patients with unstable angina pectoris of coronary heart disease and its influence on the levels of inflammatory factors.Methods A total of 100 elderly patients with unstable angina pectoris of coronary heart disease were selected as study subjects,and all were treated with atorvastatin calcium combined with aspirin.They were divided into a control group and an observation group according to different doses of atorvastatin calcium,each with 50 cases.The control group was treated with 10 mg atorvastatin calcium,and the observation group was treated with 20 mg atorvastatin calcium.Both groups were compared in terms of inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-4(IL-4)],blood lipid indicators[high density lipoprotein cholesterol(HDL-C),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)],cardiac function indicators[cardiac output(CO),stroke volume(SV),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)],therapeutic effect,and occurrence of adverse reactions.Results After treatment,the observation group had CRP of(6.06±2.06)mg/L,TNF-αof(1.33±0.37)ng/ml,and IL-6 of(117.26±26.52)pg/ml,which were lower than(10.11±2.43)mg/L,(1.89±0.41)ng/ml,and(141.52±29.33)pg/ml in the control group;the observation group had IL-4 of(2.53±0.12)pg/ml,which was higher than(1.99±0.23)pg/ml in the control group;there was statistical significance(P<0.05).After treatment,the observation group had HDL-C of(1.36±0.36)mmol/L,which was higher than(1.01±0.33)mmol/L in the control group;the observation group had TC of(3.83±0.87)mmol/L,TG of(1.88±0.52)mmol/L and LDL-C of(2.49±0.66)mmol/L,which were lower than(4.59±1.41),(2.52±0.75)and(3.01±0.81)mmol/L in the control group;there was statistical significance(P<0.05).After treatment,the observation group had CO of(5.72±1.11)L/min,SV of(72.82±9.77)ml and LVEF of(61.02±8.39)%,which were higher than(5.09±0.32)L/min,(64.51±8.03)ml and(56.32±7.27)%in the control group;the observation group had LVEDD of(51.33±0.45)mm,which was smaller than(51.83±0.57)mm in the control group;there was statistical significance(P<0.05).The total effective rate of the observation group was 98.00%,which was higher than 86.00%of the control group,and there was statistical significance(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group,and there was statistical significance(P<0.05).Conclusion Atorvastatin calcium combined with aspirin therapy is of significant value for elderly patients with unstable angina pectoris of coronary heart disease.Compared with low-dose(10 mg)atorvastatin calcium therapy,high-dose(20 mg)atorvastatin calcium therapy has more advantages,which can help to improve patients'inflammatory response and blood lipid level,regulate cardiac function,improve treatment effect and safety.