不同他汀类药物联合氯吡格雷对冠心病伴高脂血症患者的影响

Effect of Different Statins Combined with Clopidogrel on Coronary Heart Disease Patients with Hyperlipidemia

目的:研究不同他汀类药物联合氯吡格雷对冠心病(CHD)伴高脂血症患者的影响。方法:选取2021年1月—2023年12月在江西省第五人民医院治疗的80例CHD伴高脂血症患者,根据就诊日期单双号分为瑞舒伐他汀(商品名:可定)组(n=40)和阿托伐他汀(商品名:立普妥)组(n=40),可定组给予瑞舒伐他汀与氢氯吡格雷治疗,立普妥组给予阿托伐他汀联合氯吡格雷治疗,两组均连续治疗2个月。比较治疗前、治疗2个月后两组颈动脉流动力学指标、脂代谢情况、心功能、临床疗效,且记录治疗期间两组主要不良心血管事件(major adverse cardiovascular events,MACE)发生情况。结果:治疗2个月后可定组颈动脉内径、最大和最小血流速度均高于立普妥组,阻力指数低于立普妥组,差异均有统计学意义(P<0.05);治疗2个月后两组低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)及甘油三酯(TG)相比,差异均无统计学意义(P>0.05),可定组高密度脂蛋白胆固醇(HDL-C)高于立普妥组,差异有统计学意义(P<0.05);治疗前两组左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)相比,差异均无统计学意义(P>0.05);治疗2个月后可定组LVESD高于立普妥组,LVEF低于立普妥组,差异均有统计学意义(P<0.05);可定组MACE总发生率为10.00%,低于立普妥组的17.50%,可定组治疗总有效率为85.00%,高于立普妥组的72.50%,但差异均无统计学意义(P>0.05)。结论:瑞舒伐他汀联合氯吡格雷对CHD伴高脂血症患者的临床治疗效果显著,可改善患者颈动脉血流动力学及脂质代谢指标,还能促进心功能指标恢复正常,降低MACE发生率。

Objective:To study the effects of different statins combined with Clopidogrel on coronary heart disease(CHD)patients with hyperlipidemia.Method:A total of 80 CHD patients with hyperlipidemia treated in Jiangxi Fifth People's Hospital from January 2021 to December 2023 were selected and divided into Rosuvastatin(trade name:Crestor)group(n=40)and Atorvastatin(trade name:Lipitor)group(n=40)according to the odd-even date of treatment.The Crestor group was treated with Rosuvastatin and Clopidogrel.The Lipitor group was treated with Atorvastatin combined with Clopidogrel.Both groups were treated continuously for 2 months.Carotid artery flow dynamics indexes,lipid metabolism,cardiac function and clinical efficacy of the two groups were compared before treatment and 2 months after treatment,and the occurrence of major adverse cardiovascular events(MACE)between the two groups were recorded.Result:After 2 months of treatment,the carotid internal diameter,maximum and minimum blood flow velocity in Crestor group were higher than those in Lipitor group,and the resistance index was lower than that in Lipitor group,with statistical significance(P<0.05).After 2 months of treatment,there were no statistically significant differences in low density lipoprotein cholesterol(LDL-C),total cholesterol(TC)and triacylglycerol(TG)between the two groups(P>0.05),but high density lipoprotein cholesterol(HDL-C)in the Crestor group was higher than that in the Lipitor group(P<0.05).There were no significant differences in left ventricular end-systolic diameter(LVESD)and ejection left ventricular ejection fraction(LVEF)between the two groups before treatment(P>0.05).After 2 months of treatment,the LVESD of Crestor group was higher than that of Lipitor group,and LVEF was lower than that of Lipitor group,the differences were statistically significant(P<0.05).The total incidence of MACE in Crestor group was 10.00%,which was lower than 17.50%in Lipitor group,and the total effective rate was 85.00%in Crestor group,which was higher than 72.50%in Lipitor group,but the differences were not statistically significant(P>0.05).Conclusion:Rosuvastatin combined with Clopidogrel has a significant clinical effect in the treatment of CHD patients with hyperlipidemia,which can improve the indexes of carotid blood flow and lipid metabolism,promote the recovery of cardiac function indexes,and reduce the incidence of MACE.