低分子肝素联合辛伐他汀治疗急性冠脉综合征的临床研究

目的探讨低分子肝素联合辛伐他汀治疗急性冠脉综合征的临床疗效。方法选取2011年1月—2014年1月攀钢集团总医院收治的急性冠状动脉综合征患者120例,随机分为低分子肝素组、辛伐他汀组和联合治疗组,每组40例。低分子肝素组患者在常规治疗的基础上sc低分子肝素钙注射液,80 U/kg,2次/d。辛伐他汀组患者在常规治疗的基础上po辛伐他汀片,4片/次,1次/d。联合治疗组患者在常规治疗的基础上加用低分子肝素钙和辛伐他汀片,用法用量同以上两组。3组患者均连续治疗6周。治疗后,对3组患者的症状疗效和心电图疗效进行评价,同时比较3组治疗前后血脂指标和高敏C反应蛋白(hs-CRP)的水平变化。结果治疗后,低分子肝素组、辛伐他汀组、联合治疗组症状疗效总有效率分别为60.0%、67.5%、87.5%,联合治疗组的总有效率显著高于低分子肝素组和辛伐他汀组,差异均有统计学意义(P0.05)。3组心电图疗效总有效率分别为62.5%、67.5%、92.5%,联合治疗组的总有效率显著高于低分子肝素组和辛伐他汀组,差异均有统计学意义(P0.05)。治疗后,辛伐他汀组和联合治疗组患者总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)均较治疗前降低,高密度脂蛋白胆固醇(HDL-C)水平升高,但同组治疗前后差异无统计学意义。3组hs-CRP水平均较治疗前显著降低,同组治疗前后差异有统计学意义(P0.01);治疗后,联合治疗组低于以上两组,差异有统计学意义(P0.05)。结论低分子肝素联合辛伐他汀治疗急性冠脉综合征具有较好的临床疗效,可显著降低患者hs-CRP水平,优于两药单独应用。

Clinical study on low molecular heparin combined with simvastatin in treatment of acute coronary syndrome

Objective To investigate the efficacy of low molecular heparin combined with simvastatin in treatment of acute coronary syndrome. Methods Patients (120 cases) with acute coronary syndrome who came to the General Hospital of Panzhihua Iron and Steel Group from January 2011 to January 2014 were randomly divided into low molecular heparin, simvastatin and combined treatment groups, and each group had 40 cases. Patients in the low molecular heparin group were sc administered with Low Molecular Heparin Calcium Injection on the basis of conventional treatment, 80 U/kg, twice daily. Patients in the simvastatin group were po administered with Simvastatin Tablets on the basis of conventional treatment, 4 tablets/time, once daily. Patients in the combined treatment group were given Low Molecular Heparin Calcium Injection and Simvastatin Tablets, and the usage and dosage was the same to the above two groups. Three groups were continuously treated for 6 weeks. After treatment, the symptom efficacy and electrocardiogram efficacy in three groups were evaluated, while the changes of lipid indexes and hs-CRP before and after treatment were compared. Results After treatment, the symptom efficacies on the patients in the low molecular heparin, simvastatin and combined treatment groups were 60.0%, 67.5% and 87.5%, and the symptom efficacy in the combined treatment group was higher than those in the other two groups with the significant difference (P < 0.05). The electrocardiogram efficacies in three groups were 62.5%, 67.5%, and 92.5%, and the electrocardiogram efficacy in the combined treatment group was higher than those in the other two groups with the significant difference (P < 0.05). After treatment, TC, TG, and LDL-C in simvastatin and combined treatment group was reduced, HDL-C was elevated, but there was no statistically significant difference before and after treatment. The levels of hs-CRP in three groups were significantly reduced, and the differences were statistically significant before and after treatment in the same group (P < 0.01). After treatment, hs-CRP of combined the treatment group was lower than the above two groups, and the difference was statistically significant (P < 0.05). Conclusion Low molecular heparin combined with simvastatin has a good clinical efficacy in treatment of acute coronary syndrome, and can significantly reduce hs-CRP level, which is better than that of each drug used alone.