阿托伐他汀联合曲美他嗪治疗冠心病的临床观察(1)
[摘要]目的 观察阿托伐他汀联合曲美他嗪治疗冠心病的临床效果。方法 选取2015年2月～2016年3月本院诊治的冠心病患者180例，根据治疗措施不同分为三组，分别为阿托伐他汀组(n=60)、曲美他嗪组(n=60)以及阿托伐他汀联合曲美他嗪综合治疗组(n=60)，比较三组患者临床疗效。结果 综合治疗组治疗的总有效率为93.3%，显著高于阿托伐他汀组的63.3%及曲美他嗪组的68.3%，差异有统计学意义(P<0.05)。治疗前三组的三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)差异无统计学意义(P>0.05)；治疗后，综合治疗组的TG、TC和LDL-C低于其他两组。综合治疗组心绞痛发作次数及每次心绞痛发作时间，均少于其他两组(P<0.05)；综合治疗组的不良反应缓解率，也明显高于阿托伐他汀组及曲美他嗪组(P<0.05)。结论 阿托伐他汀联合曲美他嗪治疗冠心病的临床效果更理想，能改善患者生存质量，安全性高，值得推广应用。
[关键词]阿托伐他汀；曲美他嗪；冠心病；不良反应；生存质量
[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721(2016)10(a)-0050-04
[Abstract]Objective To observe the clinical effect of Atorvastatin combined with Trimetazidine in treatment of coronary heart disease (CHD).Methods 180 cases with CHD in the hospital from February 2015 to March 2016 were divided into Atorvastatin group (n=60)，Trimetazidine group (n=60) and Atorvastatin combined with Trimetazidine comprehensive treatment group (n=60) according to different therapeutic measures，clinical efficacy among three groups were compared.Results The total effective rate of comprehensive treatment group was 93.3%，significantly higher than 63.3%，68.3% of Atorvastatin group and Trimetazidine group respectively，and the difference was statistically significant (P<0.05)；triacylglycerol (TG)，total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) before treatment in three groups had no significant difference (P>0.05)；after treatment，TG，TC and LDL-C in the comprehensive treatment group was lower than those of in the other 2 groups.Frequency of angina attack and duration of angina pectoris attack in the comprehensive treatment group were less than those in the other 2 groups (P<0.05)；the remission rate of adverse reaction in the comprehensive treatment group was significantly higher than that in the other 2 groups (P<0.05).Conclusion Atorvastatin combined with Trimetazidine in treatment of CHD has more ideal clinical curative effect，can improve the quality of life of patients and high safety，and it is worth popularization and application.
[Key words]Atorvastatin；Trimetazidine；Coronary heart disease；Adverse reaction；Quality of life
冠心病(coronary heart disease，CHD)，又名缺血性心脏病，是一种由冠状动脉器质性(动力性血管痉挛或动脉粥样硬化)阻塞或狭窄，从而引起的心肌坏死(心肌梗死)或心肌缺血缺氧(心绞痛)的心脏病[1]。多以中老年人发病居多，严重威胁中老年人健康及生命。临床上，CHD的症状并不典型，主要集中于心悸、乏力及反复胸痛，偶有猝死。CHD患者的病情发作常与情绪激动、大量吸烟酗酒、季节因素等有关，其危险因素是潜在的危机。潜在危机主要由可控和不可控两个因素构成[2]。患者性别、年龄、家族史等均为不可控因素，常见的可控因素主要有超重/肥胖、糖尿病、高血压、血脂异常等。CHD易导致心肌梗死，因此选择合理有效的治疗方法尤为重要。目前，临床上常见的治疗CHD的药物有很多，其中以阿托伐他汀和曲美他嗪较为常见。传统意义上单纯使用一种药物，虽能对CHD进行治疗，但是其效果相对较差。采用阿托伐他汀联合曲美他嗪方法治疗CHD患者效果显著，且治疗后各个理化指标[三酰甘油(triacylglycerol，TG)、总胆固醇(total cholesterol，TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol，LDL-C)及高密度脂蛋白胆固醇(high density lipoprotein cholesterol，HDL-C)]相对较优[3]。现报道观察阿托伐他汀联合曲美他嗪治疗CHD的临床效果如下。 (谢燕军)
[关键词]阿托伐他汀；曲美他嗪；冠心病；不良反应；生存质量
[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721(2016)10(a)-0050-04
[Abstract]Objective To observe the clinical effect of Atorvastatin combined with Trimetazidine in treatment of coronary heart disease (CHD).Methods 180 cases with CHD in the hospital from February 2015 to March 2016 were divided into Atorvastatin group (n=60)，Trimetazidine group (n=60) and Atorvastatin combined with Trimetazidine comprehensive treatment group (n=60) according to different therapeutic measures，clinical efficacy among three groups were compared.Results The total effective rate of comprehensive treatment group was 93.3%，significantly higher than 63.3%，68.3% of Atorvastatin group and Trimetazidine group respectively，and the difference was statistically significant (P<0.05)；triacylglycerol (TG)，total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) before treatment in three groups had no significant difference (P>0.05)；after treatment，TG，TC and LDL-C in the comprehensive treatment group was lower than those of in the other 2 groups.Frequency of angina attack and duration of angina pectoris attack in the comprehensive treatment group were less than those in the other 2 groups (P<0.05)；the remission rate of adverse reaction in the comprehensive treatment group was significantly higher than that in the other 2 groups (P<0.05).Conclusion Atorvastatin combined with Trimetazidine in treatment of CHD has more ideal clinical curative effect，can improve the quality of life of patients and high safety，and it is worth popularization and application.
[Key words]Atorvastatin；Trimetazidine；Coronary heart disease；Adverse reaction；Quality of life
冠心病(coronary heart disease，CHD)，又名缺血性心脏病，是一种由冠状动脉器质性(动力性血管痉挛或动脉粥样硬化)阻塞或狭窄，从而引起的心肌坏死(心肌梗死)或心肌缺血缺氧(心绞痛)的心脏病[1]。多以中老年人发病居多，严重威胁中老年人健康及生命。临床上，CHD的症状并不典型，主要集中于心悸、乏力及反复胸痛，偶有猝死。CHD患者的病情发作常与情绪激动、大量吸烟酗酒、季节因素等有关，其危险因素是潜在的危机。潜在危机主要由可控和不可控两个因素构成[2]。患者性别、年龄、家族史等均为不可控因素，常见的可控因素主要有超重/肥胖、糖尿病、高血压、血脂异常等。CHD易导致心肌梗死，因此选择合理有效的治疗方法尤为重要。目前，临床上常见的治疗CHD的药物有很多，其中以阿托伐他汀和曲美他嗪较为常见。传统意义上单纯使用一种药物，虽能对CHD进行治疗，但是其效果相对较差。采用阿托伐他汀联合曲美他嗪方法治疗CHD患者效果显著，且治疗后各个理化指标[三酰甘油(triacylglycerol，TG)、总胆固醇(total cholesterol，TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol，LDL-C)及高密度脂蛋白胆固醇(high density lipoprotein cholesterol，HDL-C)]相对较优[3]。现报道观察阿托伐他汀联合曲美他嗪治疗CHD的临床效果如下。 (谢燕军)