曲美他嗪联合依折麦布治疗老年冠心病患者的临床效果研究  

The effect of trimetazidine combined with ezetimibe in elderly CHD patients

作　　者：谭璐[1] 汪曲[1] 张美祥[1] Tan Lu;Wang Qu;Zhang Meixiang(Department of Pharmacy,Huanggang Central Hospital,Huanggang 438000,Hubei Province,China)

机构地区：[1]黄冈市中心医院药剂科,438000

出　　处：《中华老年心脑血管病杂志》2020年第6期596-599,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨曲美他嗪联合依折麦布治疗老年冠心病患者的临床效果。方法选取老年冠心病患者140例,随机分为观察组(曲美他嗪联合依折麦布治疗)与对照组(曲美他嗪治疗),每组70例。检测受试者血清高敏C反应蛋白(hs-CRP)、CX3C趋化因子受体1(CX3CR-1)、NO和内皮素水平,采用超声测定肱动脉血流介导内皮依赖性血管舒张功能(FMD)。结果观察组临床效果总有效率明显高于对照组(98.6%vs 84.3%,P=0.003)。与治疗前比较,治疗后2组LDL-C、TC、TG、软斑块数、颈动脉内膜中层厚度、hs-CRP和CX3CR-1、内皮素水平及观察组斑块总积明显降低,HDL-C、NO、FMD水平明显升高(P<0.01)。治疗后,观察组LDL-C、TC、TG、软斑块数、斑块总积分、颈动脉内膜中层厚度、hs-CRP、CX3CR-1及内皮素水平明显低于对照组(P<0.01),HDL-C、颈动脉内径、NO及FMD水平明显高于对照组,差异有统计学意义[(1.17±0.02)mmol/L vs(0.93±0.01)mmol/L,(6.21±0.70)mm vs(5.96±0.15)mm,(72.1±9.4)μmol/L vs(59.4±8.6)μmol/L,(9.2±1.1)%vs(7.4±1.3)%,P<0.01]。结论依折麦布联合曲美他嗪治疗老年冠心病,能够有效提高疗效,改善血脂及颈动脉斑块、减少hs-CRP及CX3CR-1表达,改善患者内皮细胞功能,使冠心病患者临床获益。Objective To study the clinical effect of trimetazidine combined with ezetimibe in elderly CHD patients.Methods One hundred and forty CHD patients were divided into observation group(n=70) and control group(n=70).The patients in observation group were treated with trimetazidine combined with ezetimibe and those in control group were treated with trimetazidine only.The serum levels of hs-CRP,CX3 C chemokine receptor 1(CX3 CR-1),NO and endothelin were measured and the brachial artery blood flow-mediated endothelium-dependent vasodilating function(FMD) was tested by ultrasonography in two groups.Results The total clinical efficiency was significantly higher in observation group than in control group(98.6% vs 84.3%,P=0.003).The serum levels of LDL-C,TC,TG,hs-CRP,CX3 CR-1,endothelin were significantly lower,the number of soft plaques was significantly smaller,the score of soft plaques was lower,the carotid IMT was significantly thinner while the serum levels of HDL-C and NO were significantly higher and the FMD was significantly better in observation group after treatment than before treatment(P<0.01).The serum levels of LDL-C,TC,TG,hs-CRP,CX3 CR-1,endothelin were significantly lower while those of HDL-C and NO were significantly higher,the diameter of carotid artery was significantly longer,the FMD was significantly better in observation group than in control group after treatment(P<0.01).Conclusion Ezetimibe combined with trimetazidine can effectively improve the therapeutic efficiency,blood lipid levels and carotid artery plaques,and downregulate the expression levels of hs-CRP and CX3 CR-1 in elderly CHD patients.

关 键 词：曲美他嗪 依折麦布 冠心病 C反应蛋白质 受体 CXCR3 

分 类 号：R541.4[医药卫生—心血管疾病]