目的 探讨丹参多酚酸盐联合阿托伐他汀钙治疗冠心病合并高脂血症的临床疗效。方法 选择2012年4月—2014年9月上海市长宁区天山路街道社区卫生服务中心收治的冠心病合并高脂血症患者160例,随机分为对照组和治疗组,每组各80例。对照组于晚餐后30 min口服阿托伐他汀钙片,10 mg/次,1次/d。治疗组患者在对照组基础上静脉滴注注射用丹参酚酸盐,200 mg/次,以5%葡萄糖注射液500 mL溶解。两组患者均连续治疗8周。观察两组的临床疗效,同时比较两组治疗前后总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、心排血量(CO)、心脏指数(CI)、射血分数(EF)、左室舒张末内径(LVEDD)、血浆黏度、全血高切黏度、血小板聚集率和纤维蛋白原的变化。结果 治疗后,对照组和治疗组总有效率分别为71.25%、93.75%,两组总有效率比较差异具有统计学意义(P < 0.05)。治疗后,两组TC、LDL-C、血浆黏度均较治疗前显著降低,治疗组TG、LVEDD、血小板聚集率、全血高切黏度、纤维蛋白原降低,治疗组HDL-C、EF、CO、CI较治疗前显著升高,同组治疗前后差异有统计学意义(P < 0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P < 0.05)。结论 丹参多酚酸盐联合阿托伐他汀钙治疗冠心病合并高脂血症具有较好的临床疗效,可改善血脂、心功能和血液流变学相关指标,为临床治疗提供了一定的依据和参考。

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.