阿托伐他汀联合氯吡格雷治疗急性冠脉综合征疗效及对患者血清脑钠尿肽及心肌酶谱指标的影响  

Efficacy of atorvastatin combined with clopidogrel in treatment of acute coronary syndrome and effects on serum BNP,cTnI and myocardial enzymes indexes in patients

作　　者：封慧 FENG Hui(Department of Emergency Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院急诊科,四川成都610041

出　　处：《陕西医学杂志》2023年第7期894-897,901,共5页Shaanxi Medical Journal

基　　金：四川省科技计划项目(2021YFS0189)。

摘　　要：目的:探究阿托伐他汀联合氯吡格雷对急性冠脉综合征(ACS)患者血清脑钠尿肽(BNP)、心肌酶谱相关指标的影响及其临床疗效。方法:回顾性分析110例ACS患者的临床资料,患者均接受经皮冠状动脉介入(PCI)治疗,根据术后用药方式的不同将其分为观察组(n=55)和对照组(n=55)。其中对照组患者给予氯吡格雷治疗,观察组在对照组的基础上加用阿托伐他汀进行治疗,两组患者均连续治疗2个月。对比两组患者治疗2个月后临床疗效,比较两组患者治疗前及治疗2个月后心功能血清学指标[血清脑钠尿肽(BNP)、B型钠尿肽前体(NT-proBNP)]、心肌酶谱[肌钙蛋白(cTnI)、肌钙蛋白-T(cTn-T)、肌酸激酶同工酶MB质量(CK-MB mass)、肌红蛋白(Mb)]、脂代谢水平[甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]、血小板功能[血小板最大聚集率(MPAR)、血小板反应指数(PRI)],并统计两组患者治疗期间不良心血管事件发生率。结果:治疗两个月后,观察组患者临床治疗有效率(87.3%)明显高于对照组(70.9%)(P<0.05);治疗两个月后,两组患者BNP、NT-proBNP、心肌酶谱、血小板功能各项指标、TG、LDL-C水平均较治疗前明显降低,且观察组明显低于对照组(均P<0.05);治疗2个月后,两组患者HDL-C水平较治疗前明显上升,且观察组明显高于对照组(P<0.05);治疗期间,观察组患者不良心血管事件总发生率(5.5%)明显低于对照组(18.2%)(P<0.05)。结论:阿托伐他汀联合氯吡格雷应用于ACS患者PCI术后治疗中,可有效提升患者心脏功能,缓解心肌受损状态,对改善患者脂代谢水平及血小板功能具有积极影响,且可有效降低患者不良心血管事件发生率。Objective:To explore the effects of atorvastatin combined with clopidogrel on serum brain natriuretic peptide(BNP)and myocardial enzymes-related indexes in patients with acute coronary syndrome(ACS)and clinical efficacy.Methods:The clinical data of 110 patients with ACS were retrospectively analyzed.All patients received percutaneous coronary intervention(PCI)and were divided into observation group(55 cases)and control group(55 cases)according to the different postoperative medication methods.The control group was treated with clopidogrel and the observation group was additionally given atorvastatin on the basis of the control group.Both groups of patients were treated continuously for 2 months.The clinical efficacy after 2 months of treatment,cardiac function serological indexes[serum brain natriuretic peptide(BNP),N-terminal pro-B-type natriuretic peptide(NT-proBNP)],myocardial enzymes[cardiac troponin(cTnI),cardiac troponin T(cTn-T),creatine kinase isoenzyme MB mass(CK-MB),myoglobin(Mb)],lipid metabolism indexes[triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)]and platelet function indexes[maximum platelet aggregation rate(MPAR),platelet response index(PRI)]before treatment and after 2 months of treatment were compared between the two groups,and the incidence rates of adverse cardiovascular events in the two groups during treatment were statistically analyzed.Results:After 2 months of treatment,the effective rate of clinical treatment in observation group(87.3%)was significantly higher than that(70.9%)in control group(P<0.05).After 2 months of treatment,the BNP,NT-proBNP,myocardial enzymes,platelet function indexes,TG and LDL-C in both groups were significantly reduced in comparison with those before treatment,and the indexes in observation group were significantly lower than those in control group(all P<0.05).The HDL-C level in the two groups after 2 months of treatment was significantly increased in comparison with that before treatment,and the level in

关 键 词：急性冠脉综合征 阿托伐他汀 氯吡格雷 心肌酶谱 血清脑钠尿肽 脂代谢 血小板功能 

分 类 号：R543.3[医药卫生—心血管疾病]