Objective To observe the clinical effect of amlodipine besylate tablets combined with simvastatin tablets in treating coronary heart disease patients complicated with cerebral infarction,to investigate the impact on serum levels of TIMP-1,MMP-9 and sCD40L.Methods A total of 70 coronary heart disease patients complicated with cerebral infarction were selected in the Ninth Affiliated Hospital of Medical College from July 2014 to July 2017,and they were divided into control group and observation group,each of 35 cases. Based on conventional treatment,patients in control group received amlodipine besylate tablets,while patients in observation group received amlodipine besylate tablets combined with simvastatin tablets;both groups continuously treated for 4 weeks. Clinical effect was compared between the two groups,blood lipids index,serum levels of TIMP-1,MMP-9,sCD40L and ESS score before and after treatment were compared between the two groups,too;incidence of adverse reactions was observed during treatment.Results Clinical effect in observation group was statistically significantly better than that in control group(P<0.05). No statistically significant differences of serum level of TG,TC, HDL-C or LDL-C was found between the two groups before treatment(P>0.05);after treatment,serum levels of TG,TC and LDL-C in observation group were statistically significantly lower than those in control group,while serum HDL-C level in observation group was statistically significantly higher than that in control group(P<0.05).No statistically significant differences of serum level of TIMP-1,MMP-9 or sCD40L was found between the two groups before treatment(P>0.05),while serum levels of TIMP-1,MMP-9 and sCD40L in observation group were statistically significantly lower than those in control group after treatment(P<0.05). No statistically significant differences of ESS score was found between the two groups before treatment (P>0.05),while ESS score in observation group was statistically significantly higher than that in control group after treatment (P<0.05). No statistically significant differences of incidence of adverse reactions was found between the two groups during treatment(P>0.05).Conclusion Amlodipine besylate tablets combined with simvastatin tablets has certain clinical effect in treating coronary heart disease patients complicated with cerebral infarction,can effectively adjust the blood lipid metabolism, improve the neurological function,reduce the serum levels of TIMP-1,MMP-9 and sCD40L,with relatively high safety.%目的 观察苯磺酸氨氯地平联合辛伐他汀治疗冠心病并脑梗死的临床疗效,并探讨其对血清基质金属蛋白酶抑制剂1(TIMP-1)、基质金属蛋白酶9(MMP-9)、可溶性CD40配体(sCD40L)的影响.方法 选取2014年7月—2017年7月西安市第九医院收治的冠心病并脑梗死患者70例,采用随机数字表法分为对照组与观察组,每组35例.对照组患者在常规治疗基础上给予苯磺酸氨氯地平片治疗;在对照组基础上,观察组患者加用辛伐他汀片治疗;两组患者均连续治疗4周.比较两组患者临床疗效;比较两组患者治疗前后血脂指标,血清TIMP-1、MMP-9、sCD40L水平,欧洲卒中评分量表(ESS)评分;观察两组患者治疗期间不良反应发生情况.结果 观察组患者临床疗效优于对照组(P<0.05).治疗前两组患者血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异无统计学意义(P>0.05);治疗后与对照组比较,观察组患者血清TG、TC、LDL-C水平降低,血清HDL-C水平升高(P<0.05).治疗前两组患者血清TIMP-1、MMP-9、sCD40L水平比较,差异无统计学意义(P>0.05);治疗后与对照组比较,观察组患者血清TIMP-1、MMP-9、sCD40L水平降低(P<0.05).治疗前两组患者ESS评分比较,差异无统计学意义(P>0.05);治疗后与对照组比较,观察组患者ESS评分升高(P<0.05).两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05).结论 苯磺酸氨氯地平联合辛伐他汀治疗冠心病并脑梗死患者的临床疗效确切,可有效改善患者血脂代谢及神经功能,降低血清TIMP-1、MMP-9、sCD40L水平,且安全性较高.
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