阿托伐他汀三联用药对糖尿病并冠心病的疗效及对血小板活性因子与凝血因子的影响  

Therapeutic effect of atorvastatin triple medication on DM+CHD and its impact on platelet active factors and coagulant factors

作　　者：王黎 李华 赵波 赵春 杨萌 蒋雨玲 WANG Li;LI Hua;ZHAO Bo;ZHAO Chun;YANG Meng;JIANG Yu-ling(Department of Geriatrics,First People′s Hospital of Xiangyang City Affiliated to Hubei University of Medicine,Xiangyang,Hubei,441000,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院老年病科,湖北襄阳441000 [2]湖北医药学院附属襄阳市第一人民医院急诊科,湖北襄阳441000

出　　处：《心血管康复医学杂志》2020年第3期303-307,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察阿托伐他汀三联用药治疗糖尿病合并冠心病的临床疗效及对患者血小板活性因子、凝血因子的影响。方法:选择我院收治的118例2型糖尿病(T2DM)合并冠心病(CHD)患者作为研究对象,随机均分为二联用药组(常规治疗基础上给予维格列汀、美托洛尔治疗)、三联用药组(在二联用药基础上再给予阿托伐他汀治疗),连续治疗3个月;评估两组临床疗效,观察比较治疗前后两组患者血糖、血脂、血小板活性因子与凝血因子水平的变化情况。结果:治疗后,三联用药组临床总有效率显著高于二联用药组(93.22%比74.58%,P=0.006);与二联用药组比较,三联用药组治疗后患者血糖、血脂(除HDL-C水平显著升高外)水平及血小板活性因子CD62[(11.12±4.13)%比(9.04±3.78)%]、CD63[(13.21±4.64)%比(10.32±4.16)%],凝血因子血纤溶酶原激活抑制物(PAI)-1[(0.82±0.10)U/ml比(0.67±0.09)U/ml]、血管性假血友病因子(vWF)[(178.83±7.95)%比(160.17±6.98)%]水平均显著下降,组织型纤溶酶原激活剂(t-PA)[(0.24±0.08)U/ml比(0.29±0.11)U/ml]水平显著升高(P均<0.01)。结论:阿托伐他汀三联用药治疗糖尿病合并冠心病患者疗效更加理想,可显著改善患者血小板活性过度与凝血异常。Objective:To observe therapeutic effect of atorvastatin triple medication on type 2 diabetes mellitus(T2DM)complicated coronary heart disease(CHD)and its impact on platelet active factors and coagulant factors.Methods:A total of 118 T2DM+CHD patients treated in our hospital were randomly and equally divided into dual medication group(received vildagliptin and metoprolol based on routine treatment)and triple medication group(received atorvastatin based on dual medication group),both groups were continuously treated for three months;therapeutic effect,levels of blood glucose,blood lipids,platelet active factors and coagulant factors were observed and compared between two groups before and after treatment.Results:After treatment,total effective rate of triple medication group was significantly higher than that of dual medication group(93.22%vs.74.58%,P=0.006);compared with dual medication group after treatment,there were significant reductions in levels of blood glucose,blood lipids(except significant rise in HDL-C level),platelet active factors:CD62[(11.12±4.13)%vs.(9.04±3.78)%],CD63[(13.21±4.64)%vs.(10.32±4.16)%],coagulant factors:plasminogen activator inhibitor(PAI)-1[(0.82±0.10)U/mlvs.(0.67±0.09)U/ml]and von Willebrand factor[vWF,(178.83±7.95)%vs.(160.17±6.98)%],and significant rise in tissue plasminogen activator[t-PA,(0.24±0.08)U/mlvs.(0.29±0.11)U/ml]in triple medication group,P<0.01 all.Conclusion:Atorvastatin triple medication possesses more ideal therapeutic effect on T2DM+CHD patients.It can significantly improve platelet overactivation and abnormal coagulation in these patients.

关 键 词：冠心病 糖尿病 2型 血小板活化因子 

分 类 号：R541.4[医药卫生—心血管疾病]