替格瑞洛联合阿托伐他汀对不稳定型心绞痛患者血液流变学及炎性因子水平的影响被引量：1

Effect of Ticagrelor Combined with Atorvastatin on Hemorheology and Inflammatory Factor Levels in Patients with Unstable Angina Pectoris

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摘要目的探讨替格瑞洛联合阿托伐他汀对不稳定型心绞痛患者血液流变学及炎性因子水平的影响.方法选择2021年5月—2022年7月我院收治的72例不稳定型心绞痛患者为研究对象,根据随机数字表法分为两组.对照组(n=36)口服替格瑞洛,观察组(n=36)在对照组基础上口服阿托伐他汀,两组均持续用药3个月.对比两组的血液流变学、炎性因子水平、血脂指标、心功能指标及不良发应发生情况.结果治疗后,观察组的全血粘度、血浆粘度水平分别为(2.35±0.21)mPa·s、(1.27±0.19)mPa·s,均低于对照组的(3.24±0.34)mPa·s、(2.14±0.28)mPa·s,组间差异有统计学意义(P<0.05).治疗后,观察组的白细胞介素-6、肿瘤坏死因子-α、超敏-C反应蛋白水平分别为(13.21±5.14)pg/mL、(3.38±0.46)ng/mL、(4.82±0.72)mg/L,均低于对照组的(22.16±5.59)pg/mL、(4.62±0.64)ng/mL、(6.45±0.96)mg/L,组间差异有统计学意义(P<0.05).治疗后,观察组的高密度脂蛋白胆固醇水平为(3.27±0.41)mmol/L,高于对照组的(2.13±0.34)mmol/L,低密度脂蛋白胆固醇、三酰甘油、血清总胆固醇水平分别为(2.17±0.36)mmol/L、(1.18±0.19)mmol/L、(2.76±0.53)mmol/L,均低于对照组的(4.35±0.41)mmol/L、(2.12±0.26)mmol/L、(4.32±0.65)mmol/L,组间差异有统计学意义(P<0.05).治疗后,观察组的左心室舒张末期内径为(46.83±6.02)mm,短于对照组的(53.71±7.35)mm,左室射血分数、左室短轴缩短率分别为(61.46±5.78)%、(28.62±3.14)%,均高于对照组的(52.48±4.53)%、(23.16±2.74)%,每搏输出量为(73.57±14.31)mL/min,大于对照组的(63.24±11.79)mL/min,组间差异有统计学意义(P<0.05).两组的不良反应发生率比较,差异无统计学意义(P>0.05).结论采用替格瑞洛联合阿托伐他汀治疗不稳定型心绞痛,可有效改善患者的血液流变学,调节其炎性因子水平及血脂指标,减轻心功能损伤,且安全性高. Objective To investigate the effects of ticagrelor combined with atorvastatin on hemorheology and inflammatory factor levels in patients with unstable angina pectoris.Methods 72 patients with unstable angina pectoris admitted to our hospital from May 2021 to July 2022 were selected as the research objects and were divided into two groups according to random number table method.The control group(n=36)was given ticagrelor orally,and the observation group(n=36)was given atorvastatin orally on the basis of the control group.Both groups were given continuous medication for 3 months.The blood rheology,inflammatory factor levels,lipid indexes,cardiac function indexes and adverse reactions were compared between the two groups.Results After treatment,the levels of whole blood viscosity and plasma viscosity of the observation group were(2.35±0.21)mPa·s and(1.27±0.19)mPa·s,respectively,which were lower than(3.24±0.34)mPa·s and(2.14±0.28)mPa·s of the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the levels of interleukin-6,tumor necrosis factor-αand hypersensitive C-reactive protein in the observation group were(13.21±5.14)pg/mL,(3.38±0.46)ng/mL and(4.82±0.72)mg/L,respectively,which were lower than(22.16±5.59)pg/mL,(4.62±0.64)ng/mL and(6.45±0.96)mg/L in the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the high density lipoprotein cholesterol level in the observation group was(3.27±0.41)mmol/L,higher than(2.13±0.34)mmol/L in the control group,while the levels of low density lipoprotein cholesterol,triglyceride and serum total cholesterol were(2.17±0.36)mmol/L,(1.18±0.19)mmol/L and(2.76±0.53)mmol/L,respectively,which were lower than(4.35±0.41)mmol/L,(2.12±0.26)mmol/L and(4.32±0.65)mmol/L in the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the left ventricular end-diastolic diameter of the observation group was(46.83±6.02)mm,shorter than(53.71±7.35)mm of the control group,while the left ventricular ejection fraction and left ventricular short axis shortening rate were(61.46±5.78)%and(28.62±3.14)%,respectively,higher than that of control group(52.48±4.53)%and(23.16±2.74)%,stroke volume was(73.57±14.31)mL/min,which was greater than that of the control group(63.24±11.79)mL/min,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of ticagrelor and atorvastatin in the treatment of unstable angina pectoris can effectively improve the hemorheology of patients,regulate the levels of inflammatory factors and lipid indexes,and reduce the damage of cardiac function,with high safety.

作者杜洪明王燕厉昌美于文武 DU Hongming;WANG Yan;LI Changmei;YU Wenwu(Department of Cardiology,Ju County Hospital of Traditional Chinese Medicine,Rizhao Shandong,276599,China)

机构地区莒县中医医院心内科

出处《反射疗法与康复医学》 2023年第7期132-135,共4页 Reflexology And Rehabilitation Medicine