ABSTRACT
Objective To investigate the clinical efficacy of atorvastatin combined with trimetazidine in the treatment of coronary heart disease .Methods 80 patients with coronary heart disease were selected as the research subjects.80 patients were randomly divided into two groups .The observation group was given atorvastatin combined with trimetazidine .The control group was treated with trimetazidine .The clinical efficacy ,serum lipids levels ,hemody-namic changes and adverse reaction were observed and evaluated .Results The observation group had markedly effective in 31 cases,effective in 7 cases,ineffective in all cases ,the total effective rate was 95.0％,which was signifi-cantly higher than 77.5％of the control group(effective in 10 cases,ineffective in 9 cases,χ2 =6.818,P<0.05). The levels of TG,TC,LDL-C,HDL-C in the observation group were (1.2 ±0.2) mmol/L,(2.4 ±1.0) mmol/L, (1.5 ±0.0) mmol/L,(0.7 ±0.1) mmol/L,which in the control group were (1.6 ±0.1) mmol/L,(3.59 ± 1.2)mmol/L,(2.2 ±0.1)mmol/L,(0.9 ±0.2)mmol/L,the serum lipids levels between the two groups had statisti-cally significant differences (t =5.41,3.47,4.87,2.05,P<0.05).The whole blood viscosity (low cut),blood viscosity(high cut),plasma viscosity of the observation group were (6.98 ±0.23)mPa· s,(5.07 ±0.13)mPa· s, (1.21 ±0.12) mPa· s,which were significantly lower than those of the control group [(9.01 ±0.21) mPa· s, (6.01 ±0.01)mPa· s,(1.54 ±0.21)mPa· s,t=5.24,4.47,5.44,all P<0.05].In the observation group,0 case of dizziness,1 case of skin rash,nausea and vomiting in 1 case,the incidence rate of adverse reactions was 5.0％.In the control group,2 cases of dizziness,3 cases of skin rash,nausea and vomiting in 4 cases,the incidence rate of adverse reaction was 22.5％,there was no statistically significant difference between the two groups (χ2 =0.867,P>0.05).Conclusion The clinical curative effect of atorvastatin combined with trimetazidine in the treatment of coro -nary heart disease is accurate ,it can reduce blood fat,improve the abnormal blood rheology ,and it is safe,with less adverse reactions ,which is worthy of application and promotion .
ABSTRACT
Objective To investigate the level and significance of serum cystatin C in the patients with hypertension compli-cating left ventricular hypertrophy and atherosclerosis.Methods A total of 300 patients with essential hypertension in the cardiolo-gy department of Taizhou Municipal Central Hospital from January 2013 to December 2016 were prospectively selected as the study subjects and divided into the group A(hypertensive group,140 cases),group B[hypertension+carotid artery intima-media thickness (IM T)thickening group,75 cases],group C(hypertension+ left ventricular hypertrophy group,45 cases)and group D(hyperten-sion+carotid IMT thickening+left ventricular hypertrophy group,40 cases)according to whether complicating left ventricular hy-pertrophy and carotid atherosclerosis.The patient′s clinical data and serum cystatin C levels were collected and performed the com-parison.Results The level of LDL in the group B and D was higher than that in the group A and group C(P<0.05);the serum cystatin level in the group B,C and D was higher than that in the group A(P<0.05).The serum cystatin level in the group D was higher than that in the group B and C(P<0.05).There was positive correlation between carotid IMT with low-density lipoprotein, creatinine and cystatin C(P<0.05).The serum cystatin C level was positively correlated with left ventricular mass index(LVMI), left ventricular posterior wall thickness(LVPWT)and interval thickness(IVST)(P<0.05).Conclusion The serum cystatin C lev-el in the patients with hypertension is associated with left ventricular hypertrophy and atherosclerosis occurrence.
ABSTRACT
Objective To discuss the effect and safety about large dosage of tilofiban injection into coronary artery in patients with ST-segment elevated myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods A prospective study was conducted. Two hundred and eighteen patients with STEMI admitted into Cardiology Department of Taizhou Central Hospital were enrolled. According to the difference in dosage, they were divided into a large dosage tilofiban group (102 cases) and a routine dosage tilofiban group (116 cases). In both groups, they received the injection of load dosage of tilofiban into coronary artery during they underwent primary PCI, the load dosage being 25μg/kg in the large dosage group, and 10μg/kg in the routine dosage group. Afterwards, the dosage was kept on 0.15μg·kg-1·min-1 in both groups lasting for 18-24 hours. The flow of thrombolysis in myocardial infarction (TIMI) immediately after PCI, the return of ST-segment after operation for 2 hours, the rate of bleeding events, the rate of major adverse cardiac event [MACE, including death, re-infarction and target vessel revascularization (TVR)] and prognosis after operation for 30 days were observed. Results The ratios of the immediate reflow of TIMI 3 grade after operation and the return of ST-segment after operation for 2 hours in the large dosage tirofiban group were higher than those in the routine dosage tirofiban group [the ratio of the reflow of TIMI 3 grade:92.16%(94/102) vs. 81.90%(95/116), the ratio of the return of ST-segment after operation for 2 hours:89.22%(91/102) vs. 73.28%(85/116), both P 0.05]. Conclusion The injection of a large dosage of tilofiban into a coronary artery in patients with STEMI undergoing primary PCI is an effective and safe method to allow them to get more clinical benefits.