刘瑶　李俊峰　王安伟　张亚西　高金全

[摘要] 目的 探討瑞舒伐他汀联合复方丹参治疗冠心病合并高胆固醇血症患者的效果及其对载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）和脂蛋白酯酶水平的影响。 方法 选取2011年3月～2015年6月四川省人民医院崇州分院诊治的82例冠心病合并高胆固醇血症患者为研究对象，根据治疗方案的不同分为瑞舒伐他汀组（单独组）和瑞舒伐他汀+复方丹参组（联合组），每组各41例，比较两组心功能、血脂、氧化指标、六分钟步行试验阳性率、ApoA1、ApoB和脂蛋白酯酶水平。 结果 联合组治疗后的血脂指标均明显降低（P < 0.05）；与单独组比较，联合组血脂指标的降低幅度更为显著（P < 0.05）。联合组治疗后六分钟步行试验阳性率为29.27%，显著低于单独组的48.78%（P < 0.05）。单独组心绞痛发生次数为（3.51±0.76）次，显著高于联合组的（1.88±0.55）次（P < 0.01）。两组不良反应发生率比较差异无统计学意义（P > 0.05）。两组治疗后心输出量（CO）和左室射血分数（LVEF）明显升高（P < 0.05），心脏指数（CI）和左室舒张末内径（LVEDD）差异无统计学意义（P > 0.05）；联合组治疗后CO和LVEF的增加幅度明显优于单独组（P < 0.05）。联合组治疗后氧化型低密度脂蛋白（ox-LDL）、丙二醛（MDA）、超氧化物歧化酶（SOD）及ApoA1、ApoB和脂蛋白酯酶水平的改善程度均较单独组明显（P < 0.05）。 结论 瑞舒伐他汀联合复方丹参可提高冠心病合并高胆固醇血症的临床疗效，改善患者心功能，降低血脂、ApoA1、ApoB和脂蛋白酯酶水平。

[关键词] 瑞舒伐他汀；复方丹参；冠心病；高胆固醇血症

[中图分类号] R541.4 [文献标识码] A [文章编号] 1673-7210（2016）03（a）-0123-04

Effect of Rosuvastatin combined with Danshen Compound in the treatment of coronary heart disease with hypercholesterolemia and influence on the levels of ApoA1， ApoB and lipoprotein lipase

LIU Yao LI Junfeng WANG Anwei ZHANG Yaxi GAO Jinquan

Department of Cardiology， Chongzhou Branch of Sichuan Provincial People′s Hospital， Sichuan Province， Chongzhou 611230， China

[Abstract] Objective To explore effect of Rosuvastatin combined with Danshen Compound in the treatment of coronary heart disease with hypercholesterolemia and influence on the levels of ApoA1， ApoB and lipoprotein lipase. Methods 82 cases of coronary heart disease with hypercholesterolemia from March 2011 to June 2015 at Chongzhou Branch of Sichuan Provincial People′s Hospital were selected as research objects. The patients were randomly divided into two groups according to different treatment regimens： Rosuvastatin group （single group） and Danshen Compound plus Rosuvastatin group （combined group）， each group had 41 cases. The cardiac function， blood lipids， oxidative indexes， 6 minutes walk test positive rate， ApoA1， ApoB and lipoprotein lipase levels were compared between two groups. Results After treatment， the serum lipids indicators were significantly decreased in combined group （P < 0.05）， reduction of serum lipids indicators in combined group were more significant than those in single group （P < 0.05）. After treatment， 6 minutes walk test positive rate of combined group was 29.27%， significantly lower than that of single group （48.78%） （P < 0.05）. Angina pectoris occurrence of single group was （3.51±0.76） times， significantly higher than that of combined group [（1.88±0.55） times] （P < 0.01）. There was no significant difference on incidence rate of adverse reaction between two groups （P > 0.05）. After treatment， cardiac output （CO） and left ventricular ejection fraction （LVEF） of two groups were significantly increased （P < 0.05）， while cardiac index （CI） and left ventricular end diastolic diameter （LVEDD） were no significant differences （P > 0.05）. Increase amplitude in combined group after treatment was superior to single group （P < 0.05）. Improvement on the contents of ox-LDL， malondialdehyde （MDA）， superoxide dismutase （SOD）， ApoA1， ApoB and lipoprotein lipase in combined group were more obvious than those in single group （P < 0.05）. Conclusion Rosuvastatin combined with Danshen Compound can enhance clinical efficacy on the treatment of coronary heart disease with hypercholesterolemia， improve heart function of patients， reduce the level of lipids， ApoA1， apoB and lipoprotein lipase.

[Key words] Rosuvastatin； Danshen Compound； Coronary heart disease； Hypercholesterolemia

据世界卫生组织报告显示，我国冠心病死亡人数已高居全球第二位，严重威胁人民身体健康和生活质量[1]。血浆胆固醇水平的增高是诱发冠心病迁延或进展的关键高危因素，且降低血浆胆固醇的含量能够显著降低冠心病的发病率和死亡率[2]。瑞舒伐他汀作为新一代的他汀类药物，是最强效的调脂药物之一[3]。复方丹参则是由丹参、三七、冰片三味中药合成的中成药，具有活血化瘀的功效，对冠心病的临床症状可起到明显的改善作用[4]。据此，本研究拟探讨瑞舒伐他汀联合复方丹参治疗冠心病合并高胆固醇血症的临床效果及其对患者心功能、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）和脂蛋白酯酶水平的影响。……