阿托伐他汀联合曲美他嗪对冠心病患者血清炎症因子及心绞痛再发作的影响  

Effect of Atorvastatin Combined with Trimetazidine on Serum Inflammatory Factors and Angina Pectoris Attack in Patients with Coronary Heart Disease

作　　者：谭亚波 李健雄 马立民[1] TAN Ya-bo;LI Jian-xiong;MA Li-min(Department of Emergency,Second People's Hospital of Tianjin Wuqing District,Tianjin 301700,China)

机构地区：[1]天津市武清区第二人民医院急诊科,天津301700

出　　处：《中国血液流变学杂志》2023年第1期69-72,共4页Chinese Journal of Hemorheology

摘　　要：目的探讨阿托伐他汀(ATO)联合曲美他嗪(TMZ)治疗冠心病(CHD)对患者心功能及其与患者心绞痛发作风险的关系。方法选取2018年5月-2019年5月在天津市武清区第二人民医院治疗的86例CHD患者,分为对照组和观察组各43例。对照组给予盐酸TMZ治疗,观察组在对照组的基础上加用ATO。观察比较两组心功能、血清炎症因子及心绞痛再发风险有无差异。结果观察组治疗后LVEF高于对照组,LVEDD、LVESD均低于对照组(P<0.05);观察组Hcy、NT-proBNP低于对照组(P<0.05);对照组随访期间发生心绞痛14次,而观察组随访期间发生心绞痛6次,观察组心绞痛发生风险显著低于对照组(HR=0.36,95%CI:0.15~0.87,P<0.05)。复发组和未复发组治疗后Hcy水平分别为(28.12±10.34)μmol/L和(11.98±4.34)μmol/L,复发组显著高于未复发组(P<0.05)。以治疗后Hcy为参考,其预测CHD患者心绞痛复发的敏感性为98.48%(95%CI:91.84%~99.96%),特异性为85.10%(95%CI:62.11%~95.56%),预测的ROC曲线下面积AUC为0.89(95%CI:0.77~1.00)。结论ATO联合TMZ可通过降低患者血清炎症因素水平改善CHD患者心功能,降低心绞痛再发风险。同时,Hcy可作为CHD患者心绞痛复发风险的血清标志物。Objective To investigate the relationship between atorvastatin(ATO)combined with trimetazidine(TMZ)in the treatment of coronary heart disease(CHD)on cardiac function and the risk of angina attack.Methods A total of 86 CHD patients treated in Second People's Hospital of Tianjin Wuqing District from May 2018 to May 2019 were selected and divided into control group and observation group(43 cases in each group).The control group was additionally treated with TMZ hydrochloride,and the observation group was additionally treated with ATO.Cardiac function,serum inflammatory factors and recurrence risk of angina pectoris were observed and compared between the two groups.Results LVEF of observation group was higher than that of control group,LVEDD and LVESD were lower than those of control group(P<0.05).Hcy and NT-proBNP in observation group were lower than those in control group(P<0.05).Angina pectoris occurred 14 times in the control group and 6 times in the observation group,and the risk of angina pectoris in the observation group was significantly lower than that in the control group(HR=0.36,95%CI:0.15-0.87,P<0.05).The level of Hcy in the recurrence group and non-recurrence group after treatment was(28.12±10.34)μmol/L and(11.98±4.34)μmol/L,which was significantly higher in the recurrence group than that in the non-recurrence group(P<0.05).The sensitivity to predict the recurrence of angina pectoris in CHD patients was 98.48%(95%CI:91.84%-99.96%)based on Hcy level after treatment,and the specificity was 85.10%(95%CI:62.11%-95.56%).The area under the ROC curve predicted by AUC was 0.89(95%CI:0.77-1.00).Conclusion ATO combined with TMZ can improve the cardiac function of CHD patients by reducing the level of serum inflammatory factors and reduce the risk of recurrent angina pectoris.Hcy can be used as a serum marker for recurrence risk of angina pectoris in CHD patients.

关 键 词：降血脂治疗 扩冠 心功能 再发 心绞痛 疗效 

分 类 号：R541.4[医药卫生—心血管疾病]