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目的探讨阿托伐他汀钙联合硫酸氢氯吡格雷对冠状动脉病变的影响。方法 2013年8月—2017年1月选择在南通市肿瘤医院诊治的急性冠状动脉综合征患者122例,根据随机信封抽签原则平均分为观察组与对照组各61例,两组都给予经皮冠状动脉介入治疗,对照组给予硫酸氢氯吡格雷辅助治疗,观察组给予阿托伐他汀钙联合硫酸氢氯吡格雷辅助治疗,都治疗观察4周。比较两组临床疗效,在治疗前后采用超声测量左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)变化,采用免疫荧光标记法测定血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)。结果观察组的治疗总有效率为96.7%,对照组为82.0%,观察组的总有效率明显高于对照组,差异有统计学意义(P<0.05)。观察组与对照组治疗后的左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)值都明显低于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);同时治疗后观察组的LVEDD和LVESD值也明显低于对照组,差异有统计学意义(P<0.05)。观察组与对照组治疗后的GPⅡb/Ⅲa值分别为(10.22±3.12)%和(14.32±2.98)%,都明显低于治疗前的(20.98±3.30)%和(21.22±2.98)%,差异有统计学意义(P<0.05);观察组也明显低于对照组,差异有统计学意义(P<0.05)。所有患者随访6个月,观察组的心律失常、出血与死亡等发生率为3.3%,对照组为19.7%,观察组明显少于对照组,差异有统计学意义(P<0.05)。结论阿托伐他汀钙和硫酸氢氯吡格雷在急性冠状动脉综合征治疗中的应用能提高心功能,降低GPⅡb/Ⅲa的表达,从而提高近期与远期疗效。
Objective To investigate the effect of atorvastatin combined with clopidogrel bisulfate on coronary lesions. Methods From August 2013 to January 2017, 122 patients with acute coronary syndrome who were diagnosed and treated in Cancer Hospital of Nantong City were randomly divided into observation group and control group according to the principle of random ensemble. Each group was given 61 cases of percutaneous Coronary interventional therapy, control group given clopidogrel hydrogen sulfate adjuvant therapy, the observation group was given atorvastatin calcium combined with clopidogrel bisulfate adjuvant therapy, were treated for 4 weeks. The clinical efficacy of the two groups were compared before and after treatment. Left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were measured before and after treatment. Platelet glycoprotein Ⅱb / Ⅲa (GPⅡb / Ⅲa) was detected by immunofluorescence staining. Results The total effective rate was 96.7% in the observation group and 82.0% in the control group. The total effective rate in the observation group was significantly higher than that in the control group (P <0.05). The LVEDD and LVESD of the observation group and the control group were significantly lower than those before treatment (P <0.05), and the difference was statistically significant (P <0.05) After treatment, the LVEDD and LVESD values in the observation group were also significantly lower than those in the control group, with statistical significance (P <0.05). The GPⅡb / Ⅲa values in the observation group and the control group after treatment were (10.22 ± 3.12)% and (14.32 ± 2.98)%, respectively, which were significantly lower than those before treatment (20.98 ± 3.30)% and (21.22 ± 2.98)%, respectively (P <0.05). The observation group was also significantly lower than the control group, the difference was statistically significant (P <0.05). All patients were followed up for 6 months. The incidence of arrhythmia, bleeding and death in the observation group was 3.3% and that in the control group was 19.7%. The observation group was significantly less than the control group (P <0.05). Conclusions The application of atorvastatin calcium and clopidogrel bisulfate in the treatment of acute coronary syndrome can improve cardiac function and reduce the expression of GP Ⅱ b / Ⅲ a, so as to improve the short-term and long-term effects.