阿托伐他汀联合丹参川芎嗪对冠心病患者CysC、心功能及颈动脉斑块的影响

The effects of atorvastatin combined with salviae miltiorrhizae and Ligustrazine on CysC,cardiac function and carotid plaque in patients with coronary heart disease

目的 :探讨阿托伐他汀联合丹参川芎嗪对冠心病患者血清胱抑素C(Cys C)、心功能及颈动脉斑块的影响。方法 :选取2015年5月～2017年5月期间我院收治的冠心病患者298例,按随机数字表分为观察组和对照组,每组149例。对照组采用阿托伐他汀进行治疗,观察组在此基础上联合丹参川芎嗪进行治疗,治疗后对比两组患者的临床疗效、Cys C水平、颈动脉斑块情况、血脂水平、血液流变学指标、心功能及并发症发生情况。结果 :治疗后,观察组的总有效率明显高于对照组,差异具有统计学意义。观察组治疗后第2、3、4周的血清Cys C水平均显著低于对照组,差异有统计学意义。观察组颈动脉内膜-中层厚度(IMT)及颈动脉斑块面积显著低于对照组,以上差异均有统计学意义。观察组患者的总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白(LDL-C)改善程度均明显高于对照组,以上差异均有统计学意义。观察组治疗后的血液流变学指标全血高切黏度(Nbh)、全血低切黏度(Nbl)、血浆比黏度(Np)及纤维蛋白(Fb)含量改善程度均明显高于对照组,以上差异均有统计学意义。观察组患者的心功能指标左心室射血分数(LVEF)、左心室收缩末期容量(LVESV)及左心室舒张末压力(LVEDP)含量改善程度均明显高于对照组,以上差异均有统计学意义。随访6个月后,观察组患者短暂性脑缺血发作(TIA)发生率、复发率及并发症发生率均显著低于对照组,差异具有统计学意义。结论 :阿托伐他汀联合丹参川芎嗪治疗冠心病临床疗效确切,显著降低患者血清Cys C水平和血脂水平,改善心功能及颈动脉斑块情况,安全可靠,值得在临床上进一步推广应用。

Objective To investigate the effects of atorvastatin combined with danshen ligustrazine on the serum cystatin C(CysC),cardiac function and carotid plaque in patients with coronary heart disease.Methods 298 patients with coronary heart disease were selected from May 2015 to May 2017 in our hospital.According to the intraoperative monitoring method,all patients were divided into observation group and control group,with 149 cases per group.Control group used atorvastatin treatment,observation group used atorvastatin combined with salvia miltiorrhiza ligustrazine treatment,compared two groups of patients after treatment of clinical curative effect,CysC level,carotid plaques,lipid levels,blood rheology indexes,cardiac function and complications.Results After treatment,the total effective rate of observation group was significantly higher than the control group,and the difference was statistically significant.The serum CysC levels in the 2,3 and 4 weeks after treatment were significantly lower than those in the control group,and the difference were statistically significant.Observation group carotid endometrium thickness(IMT)and carotid artery plaque area were significantly lower than the control group,and the difference were statistically significant.The improvement of total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)in the observation group were significantly higher than those in the control group,and the difference were statistically significant.Observation group after treatment of hemorheology index(Nbh)whole blood high shear viscosity,whole blood low shear viscosity(Nbl),plasma viscosity ratio(Np)and fibroectin(Fb)degree of improvement were significantly higher than that of control group,the above differences were statistically significant.Observation group of patients with cardiac function index of left ventricular ejection fraction(LVEF),left ventricular end systolic volume(LVESV)and left ventricular end-diastolic pressure(LVEDP)levels were significantly higher than that of control group,improve the above differences were statistically significant.After six months of follow-up,the incidence rate,recurrence rate and complication rate of transient ischemic attack(TIA)in the observation group were significantly lower than those in the control group,and the difference were statistically significant.Conclusion Atorvastatin with salvia miltiorrhiza ligustrazine therapy of coronary heart disease has good clinical curative effect,significantly upregulates serum CysC level and blood lipid levels,improves heart function and carotid plaques,safe and reliable,worthy of further popularization and application in clinic.