他汀类药物强化治疗对首诊冠状动脉粥样硬化性心脏病患者血脂、动脉内皮功能、心肌能量代谢的影响  

Effects of Intensive Statin Therapy on Blood Lipids, Arterial Endothelial Function and Myocardial Energy Metabolism in Patients with Coronary Heart Disease First Diagnosed

作　　者：白森 BAI Sen(Dry Diagnosis Department,Fushun Hospital of traditional Chinese Medicine,Fushun 113008,China)

机构地区：[1]抚顺市中医院干诊科,辽宁抚顺113008

出　　处：《中国药物经济学》2021年第9期111-114,120,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨他汀类药物强化治疗对首诊冠状动脉粥样硬化性心脏病患者血脂、动脉内皮功能、心肌能量代谢的影响。方法选取2019年4—10月于抚顺市中医院诊治的首诊冠状动脉粥样硬化性心脏病患者86例作为研究对象,利用随机数字表法分为正常剂量组与强化剂量组,各43例。正常剂量组在常规治疗基础上采用口服瑞舒伐他汀钙片5 mg/d治疗,强化剂量组在常规治疗基础上采用口服瑞舒伐他汀钙片20 mg/d治疗。比较两组血脂、一氧化氮(NO)、内皮素(ET)、肌酸激酶(CK)、心肌能量消耗(MEE)及临床疗效。结果治疗后,正常剂量组与强化剂量组总胆固醇、三酰甘油、低密度脂蛋白、ET、CK水平及MEE值较治疗前明显降低,强化剂量组总胆固醇、三酰甘油、低密度脂蛋白、ET、CK水平及MEE值显著低于正常剂量组,差异有统计学意义(P<0.05);正常剂量组与强化剂量组高密度脂蛋白、NO水平较治疗前明显升高,强化剂量组高密度脂蛋白、NO水平显著高于正常剂量组,差异有统计学意义(P<0.05)。治疗后,强化剂量组有效率为93.02%,正常剂量组有效率为69.77%,强化剂量组明显高于正常剂量组(P<0.05)。结论瑞舒伐他汀强化治疗冠状动脉粥样硬化性心脏病可通过抑制3-羟基-3-甲基戊二酸单酰辅酶A(HMG-Co A)还原酶活性,阻碍胆固醇合成,增加细胞间黏附因子-1的活性,抑制CK分泌,缓解心肌缺血再灌注损伤,发挥降脂、稳定斑块、改善动脉内皮功能、降低心肌能量代谢速率等作用。Objective To explore the effects of intensive statin therapy on blood lipids, arterial endothelial function, and myocardial energy metabolism in patients with coronary heart disease first diagnosed. Methods A total of 86 first-diagnosed coronary heart disease patients admitted to Fushun Hospital of traditional Chinese Medicine from April 2019 to October 2019 were selected as the research objects. By using random number table method, they were divided into a normal dose group and an enhanced dose group, with 43 cases in each group. The normal dose group was treated with oral rosuvastatin calcium tablets 5 mg/d on the basis of conventional treatment, and the intensive dose group was treated with oral rosuvastatin calcium tablets 20 mg/d on the basis of conventional treatment. The blood lipids, nitric oxide(NO), endothelin(ET), creatine kinase(CK), myocardial energy expenditure(MEE) and clinical efficacy were compared between the 2 groups. Results After treatment, the total cholesterol, triglycerides, low-density lipoprotein, ET level, CK content and MEE value of the normal dose group and the enhanced dose group were significantly reduced compared to those before treatment. The total cholesterol, triglycerides, and low density lipoprotein, ET level, CK content and MEE value of the enhanced dose group were significantly lower than the normal dose group, the difference was statistically significant(P<0.05);the high density lipoprotein and NO levels of the normal dose group and the enhanced dose group were significantly increased compared with those before treatment, and the enhanced dose group had high density and the levels of lipoprotein and NO were significantly higher than the normal dose group(P<0.05). After treatment, the effective rate of the enhanced dose group was 93.02%, the effective rate of the normal dose group was 69.77%, and the enhanced dose group was significantly higher than the normal dose group(P < 0.05). Conclusion Rosuvastatin intensive treatment of coronary atherosclerotic heart disease can inhi

关 键 词：瑞舒伐他汀 冠状动脉粥样硬化性心脏病 血脂 血管内皮因子 心肌能量 

分 类 号：R541.4[医药卫生—心血管疾病] R972[医药卫生—内科学]