阿司匹林联合瑞舒伐他汀对冠状动脉狭窄<50%患者的疗效及生化指标的影响探究

Effect of aspirin combined with rosuvastatin on the therapeutic effect and biochemical indexes of patients with<50%coronary artery stenosis

目的探究阿司匹林联合瑞舒伐他汀对冠状动脉狭窄<50%患者的疗效及生化指标的影响。方法86例冠状动脉狭窄<50%的患者,随机分为对照组(43例,瑞舒伐他汀治疗)和联合组(43例,阿司匹林联合瑞舒伐他汀治疗)。比较两组临床疗效、血脂代谢指标、血清炎症反应指标、颈动脉彩超指标及心血管事件发生情况。结果联合组治疗总有效率97.67%高于对照组的83.72%(P<0.05)。治疗后,两组血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前降低,高密度脂蛋白胆固醇(HDL-C)水平均较治疗前升高,且联合组血清总胆固醇(4.28±1.06)mmol/L、甘油三酯(1.43±0.74)mmol/L、LDL-C(2.68±0.75)mmol/L均低于对照组的(4.81±0.95)、(1.81±0.62)、(3.06±0.69)mmol/L,HDL-C(1.48±0.39)mmol/L高于对照组的(1.29±0.41)mmol/L(P<0.05)。治疗后,两组血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平均较治疗前降低,且联合组TNF-α(26.65±3.04)ng/L、hs-CRP(4.39±1.10)mg/L、IL-6(25.59±2.88)ng/L均低于对照组的(31.19±3.36)ng/L、(5.32±1.06)mg/L、(33.37±3.59)ng/L(P<0.05)。治疗后,两组颈动脉内膜中层厚度(IMT)、颈动脉斑块面积均较治疗前减小,且联合组IMT(1.09±0.22)mm、颈动脉斑块面积(0.09±0.02)mm^(2)均小于对照组的(1.21±0.16)mm、(0.16±0.03)mm^(2)(P<0.05)。联合组心血管事件发生率2.33%低于对照组的16.28%(P<0.05)。结论阿司匹林联合瑞舒伐他汀治疗冠状动脉狭窄<50%患者的疗效显著,可有效改善患者血脂代谢水平,减轻炎症反应,且心血管事件发生率低,安全性高。

Objective To explore the effect of aspirin combined with rosuvastatin on the therapeutic effect and biochemical indexes of patients with<50%coronary artery stenosis.Methods 86 patients with<50%coronary artery stenosis were randomly divided into a control group(43 cases,rosuvastatin treatment)and a combination group(43 cases,aspirin combined with rosuvastatin treatment).The clinical efficacy,lipid metabolism indexes,serum inflammatory markers,carotid ultrasound indicators and cardiovascular events were compared between the two groups.Results The total effective rate of 97.67%in the combination group was higher than 83.72%in the control group(P<0.05).After treatment,the serum total cholesterol,triglyceride and low density lipoprotein cholesterol(LDL-C)levels in both groups were lower than those before treatment,and the high density lipoprotein cholesterol(HDL-C)level was higher than that before treatment;in the combination group,the serum total cholesterol was(4.28±1.06)mmol/L,the triglyceride was(1.43±0.74)mmol/L and LDL-C was(2.68±0.75)mmol/L,which were lower than(4.81±0.95),(1.81±0.62)and(3.06±0.69)mmol/L in the control group;HDL-C of(1.48±0.39)mmol/L in the combination group was higher than(1.29±0.41)mmol/L in the control group(P<0.05).After treatment,the serum levels of tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)in both groups were lower than those before treatment;the combination group had TNF-αof(26.65±3.04)ng/L,hs-CRP of(4.39±1.10)mg/L and IL-6 of(25.59±2.88)ng/L,which were lower than(31.19±3.36)ng/L,(5.32±1.06)mg/L and(33.37±3.59)ng/L in the control group(P<0.05).After treatment,the carotid intima-media thickness(IMT)and carotid plaque area decreased in both groups compared with those before treatment;the combination group had IMT of(1.09±0.22)mm and carotid plaque area of(0.09±0.02)mm^(2),which were lower than(1.21±0.16)mm and(0.16±0.03)mm^(2) in the control group(P<0.05).The incidence of cardiovascular events in the combination group was 2.33%,which was lower than 16.28%in the control group(P<0.05).Conclusion Aspirin combined with rosuvastatin has significant efficacy in the treatment of patients with<50%coronary artery stenosis,which can effectively improve the level of lipid metabolism in patients,reduce inflammation,and have a low incidence of cardiovascular events and high safety.