目的 探討丹參多酚酸鹽聯(lián)合阿托伐他汀鈣治療冠心病合并高脂血癥的臨床療效。方法 選擇2012年4月—2014年9月上海市長寧區(qū)天山路街道社區(qū)衛(wèi)生服務(wù)中心收治的冠心病合并高脂血癥患者160例,隨機(jī)分為對照組和治療組,每組各80例。對照組于晚餐后30 min口服阿托伐他汀鈣片,10 mg/次,1次/d。治療組患者在對照組基礎(chǔ)上靜脈滴注注射用丹參酚酸鹽,200 mg/次,以5%葡萄糖注射液500 mL溶解。兩組患者均連續(xù)治療8周。觀察兩組的臨床療效,同時(shí)比較兩組治療前后總膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、心排血量(CO)、心臟指數(shù)(CI)、射血分?jǐn)?shù)(EF)、左室舒張末內(nèi)徑(LVEDD)、血漿黏度、全血高切黏度、血小板聚集率和纖維蛋白原的變化。結(jié)果 治療后,對照組和治療組總有效率分別為71.25%、93.75%,兩組總有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療后,兩組TC、LDL-C、血漿黏度均較治療前顯著降低,治療組TG、LVEDD、血小板聚集率、全血高切黏度、纖維蛋白原降低,治療組HDL-C、EF、CO、CI較治療前顯著升高,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P < 0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P < 0.05)。結(jié)論 丹參多酚酸鹽聯(lián)合阿托伐他汀鈣治療冠心病合并高脂血癥具有較好的臨床療效,可改善血脂、心功能和血液流變學(xué)相關(guān)指標(biāo),為臨床治療提供了一定的依據(jù)和參考。

Objective To observe the clinical effect of salvianolate combined with atorvastatin calcium in treatment of coronary heart disease complicated with hyperlipidemia. Methods Coronary heart disease complicated with hyperlipidemia (160 cases) in Tianshan Road Community Health Service Center of Changning District in Shanghai from April 2012 to September 2014 were randomly divided into control and treatment groups, and each group had 80 cases. The patients in the control group were po administered with Atorvastatin Calcium Tablets 30 min after dinner, 10 mg/time, once daily. The patients in the treatment group were iv administered with Salvianolate for injection, 200 mg/time dissolving with 5% glucose injection 500 mL. Two groups were treated for 8 weeks. After treatment, the efficacy was evaluated, and the changes of TC, TG, HDL-C, LDL-C, CO, CI, EF, LVEDD, plasma viscosity, whole blood high shear viscosity, platelet aggregation rate, and fibrinogen in two groups were compared. Results The efficacies in the control and treatment groups were 71.25% and 93.75%, respectively, and there were differences between two groups (P < 0.05). After treatment, TC, LDL-C, and plasma viscosity in two groups significantly reduced, while TG, LVEDD, platelet aggregation rate, whole blood high shear viscosity, and fibrinogen in the treatment group were significantly decreased, but HDL-C, EF, CO, and CI in the treatment group were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusion Salvianolate combined with atorvastatin calcium has good clinical effect in treatment of coronary heart disease complicated with hyperlipidemia, and can improve the related parameters of blood lipids, heart function and blood rheology, which provides the certain reference for clinical treatment.