摘要
目的 分析乙肝病毒(HBV)感染史对经阿托伐他汀治疗的冠心病患者肝功能、脂代谢及抗血小板效果的影响。方法 选取2015年1月-2020年2月80例江西省萍乡市第二人民医院收治的HBV感染史冠心病患者为感染组,另选择80例无HBV感染史者为阴性组,入组后均予以阿托伐他汀降脂、阿司匹林联合氯吡格雷抗血小板治疗。随访12周,比较两组肝功能[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TB)]、肝损伤程度、脂代谢[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]、血脂达标率、血小板聚集抑制率、氯吡格雷抵抗及阿司匹林抵抗发生率,并统计感染组肝炎复发情况。结果 治疗后,感染组ALT、AST、TB水平升高幅度大于阴性组(P<0.05);感染组肝损伤发生率15.00%,高于阴性组1.25%(P<0.05);感染组TC、LDL-C下降幅度小于阴性组(P<0.05),感染组TC达标率70.00%、LDL-C达标率43.75%均低于阴性组的83.75%、61.25%(P<0.05);HBV感染组血小板聚集抑制率低于阴性组(P<0.05),氯吡格雷抵抗发生率11.25%,高于阴性组的2.50%(P<0.05)。随访期间,感染组有1例肝炎复发。结论 HBV感染史可加重经阿托伐他汀治疗的冠心病患者肝损害,且影响患者降脂、抗血小板效果,临床应引起重视。
OBJECTIVE To observe the effect of history of hepatitis B virus(HBV) infection on liver function, lipid metabolism and antiplatelet in patients with coronary heart disease treated by atorvastatin. METHODS From Jan 2015 to Feb 2020, 80 coronary heart disease patients with a history of HBV infection treated in Pingxiang Second People′s Hospital of Jiangxi province were enrolled in the infection group, and another 80 coronary heart disease patients without a history of HBV infection were in the negative group. All patients were given lipid-lowering therapy with atorvastatin and antiplatelet therapy with aspirin and ticagrelor. After 12 weeks of follow-up, the liver function, including alanine aminotransferase(ALT), aspartate aminotransferase(AST) and total bilirubin(TB), liver injury degree, lipid metabolism such as total cholesterol(TC), triglyceride(TG) and low-density lipoprotein cholesterol(LDL-C), compliance rates of blood lipids, platelet aggregation inhibition rate, incidence rates of clopidogrel resistance and aspirin resistance were compared between the two groups, and the hepatitis recurrence in the infection group was analyzed. RESULTS After treatment, the increased levels of ALT, AST and TB in the infection group were significantly greater than those in the negative group(P<0.05). The incidence rate of liver injury in the infection group was significantly higher than that in the negative group(15.00% vs. 1.25%)(P<0.05). After treatment, the decreased levels of TC and LDL-C in infection group were significantly smaller than those in the negative group(P<0.05). The TC and LDL-C compliance rates in the HPV infection group were significantly lower than those in the negative group(70.00% vs. 83.75%, 43.75% vs. 61.25%)(P<0.05). The platelet aggregation inhibition rates in HBV infection group was significantly lower than that in negative group(P<0.05), and the incidence rate of clopidogrel resistance was 11.25%, which was significantly higher than that of 2.50% in the negative group(P<0.05). During follow-up,
作者
周敏
王金梅
廖英坚
ZHOU Min;WANG Jin-mei;LIAO Ying-jian(Pingziang No.2 People's Hospital,Pingiang,Jiangri 337000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第7期1004-1008,共5页
Chinese Journal of Nosocomiology
基金
江西省自然科学基金资助项目(20195648)。
关键词
冠心病
阿托伐他汀
乙肝病毒感染史
肝脏损伤
脂代谢
抗血小板治疗
Coronary heart disease
Atorvastatin
History of hepatitis B virus infection
Liver injury
Lipid metabolism
Antiplatelet therapy
