合并乙型病毒性肝炎的冠心病病人应用他汀类药物临床观察研究才让卓玛MMma青海省人民医院摘要：冃的分析应用不同剂量阿托伐他汀钙联合降脂胶囊对合并乙型病毒性肝炎的冠心病病人的血脂指标、肝功和内皮功能的影响。方法随机选取某院2014年1月PH年1月接受治疗的120例合并乙型病毒性肝炎的冠心病病人，采用随机数字表法分为A组、B组和C组，每组40例。A组病人给予10mg/d的阿托伐他汀钙联合降脂胶囊治疗，B组病人给予20mg/d的阿托伐他汀钙联合降脂胶囊治疗，C组病人给予5mg/d的阿托伐他汀钙联合降脂胶囊治疗。比较3组病人在治疗前和治疗后6个月的血脂指标三酰甘油(ThreeGlycerol,TG)、总胆固醇(TatalCholesterol,TC)、低密度脂蛋白胆固醇(LowDensityLipoproteinCholesterol,LDL-C)、高密度脂蛋白胆固醇(HighDensityLipoproteinCholesterol,IIDL-C)、肝功血清谷丙转氨酶(Alaninetransaminase,ALT)水平、肝功能损害发生率、内皮功能指标内皮素T(endothelin-1,ETT)和-亠氧化氮(nitricoxide,NO)水平。结果治疗后，B组病人的血清ALT水平和肝功能损害发生率比A组和C组明显升高，差异有统计学意义(P<0.05),A组和C组病人的ALT水平和肝功能损害发生率差异均无统计学意义(P>0.05);C组病人的TC、TG、LDI-C和ET-1水平均比A组和B组明显升高，差异有统计学意义(P<0.05),C组病人的NO水平比A组和B组明显降低，差异有统计学意义(P<0.05),A组和B组的ET-l、NO、TC、TG、LDL-C水平差异均无统计学意义(P>0.05),3组病人的HDL-C水平差异无统计学意义(P>0.05)。结论剂量为10mg/d的阿托伐他汀钙联合降脂胶囊方案的疗效最佳，能有效地减轻合并乙型病莓性肝炎的冠心病病人的肝功损害，调节机体血脂代谢，且不会影响病人内皮功能的恢复，值得临床广泛应用。关键词：冠心病;乙型病毒性肝炎;内皮功能;阿托伐他汀钙;肝功能损害;作者简介：才让卓玛(1975-),女，副主任医师，主要从事心血管内科疾病的诊断和治疗工作，E-mai1:13389758061@163.com收稿日期:2017-07-28基金：青海省卫生计生科研指导性计划课题(2017-wjzdx-30)ClinicalobservationofstatinsinpatientswithcoronaryheartdiseasecomplicatedwithhepatitisBCAIRangZhuomaCHENXiuyingLIANXinlongGEXinyingYANGYongxinQinghaiProvincePeople'sHospital;Abstract：ObjectiveToinvestigatetheinfluenceofatorvastatincalciumofdifferentdosecombinedwithjiangzhicapsuleonthebloodlipid,liverfunctionandendothelialfunctionofpatientscoronaryheartdiseasewithhepatitisB.MethodsAtotalof120patientswithcoronaryheartdiseaseandhepatitisBinourhospitalfromJanuary2014toJanuary2017wererandomlyselectedanddividedintogroupAandgroupB,40patientseachgroup.ThepatieiitsofgroupAweretreatedwithatorvastatincalcium(10mg/d)withjiangzhicapsule,patientsofgroupBweretreatedwithatorvastatincalcium(20mg/d)withjiangzhicapsule,andpatientsofgroupCweretreatedwithatorvastatincalcium(5mg/d)withjiangzhicapsule.ThebloodlipidindexTG,TC,LDL-C,HDL-C,1iverfunction,ALT,ET~1,NOandtheincidenceof1iverdysfunctionoftwogroupswerecomparedbeforeand6monthsaftertreatment.ResultsAftertreatment,thelevelofALTandincidenceofliverfunctiondamageingroupBweresignificantlyhigherthanthoseingroupAandC,andtherewassignificantlydifferenee(P〈0.05)•Aftertreatment,thelevelofALTandincidenceofliverfunctiondamagebetweengroupAandCwerenosignificantlydifference(P>0.05)・ThelevelofTO,TG,ET~1andLDL-CinthegroupCaftertreatmentweresignificantlyhigherthanthoseinthegroupAandB,andtherewassignificantlydifference(P<0.05).ThelevelofNOinthegroupCaftertreatmentweresignificantly1owerthanthoseinthegroupAandB,andtherewassignificantlydifference(P<0.05).ThelevelofET-1,NO,TO,TGandLDL-CbetweengroupAandBwerenosignificantlydifference(P>0.05).Aftertreatment,thelevelofHDL-Cbetweenthreegroupswerenosignificantlydifference(P>0.05).Conclusi...