The Postprandial Lipid Change Of Patient Suffering From Coronary Heart Disease And The Effect Of Using JZTLRJN

Objective: Dyslipidemia is the most important independent risk factors ofcoronary heart disease, especially high total cholesterol (TC) and highlow-density lipoprotein(LDL). Therefore, statins become the essential drugsthat can prevention from contracting coronary heart disease, reduce theincidence of coronary heart disease, decrease coronary heart diseasecardiovascular events, reduce coronary heart disease mortality. However, foralong time, the relationship between hypertriglyceridemia and coronary heartdisease has dispute. Many studies have shown that hypertriglyceridemia is arisk factor for coronary heart disease, but some studies have shown therelationship between triglyceride and coronary heart disease is not closelyrelated. In recent years, studies have shown that there may be closerelationship between postprandial hypertriglyceridemia and coronary heartdisease. A part of the lipid guidelines require that treat hypertriglyceridemiaand determine compliance standards. However, taking into consideration thatstatins combine with fibrates can increase side effects, so, many clinicians usestatins only to treat mixed hyperlipidemia, but no treatment ofhypertriglyceridemia. Thus, there is a great clinical significance that furtherstudy of the relationship between triglyceride and coronary heart disease,especially the relationship between high postprandial hyperlipidemia andcoronary heart disease, we should explore a medicine that can not only lowerhigh postprandial lipid but also that it is safe to combine with statins.JZTLRJN has been widely used in clinical, its main function is to reducetriglyceride, who contains curcumin that can protect liver function, but, thereis no study on the effects of postprandial lipids. Therefore, the main objectiveof this project is to observe the relationship between coronary heart diseaseand postprandial lipid, and changes in lowering postprandial lipid of JZTLRJN, especially, the security of JZTLRJN combined with statins.Methods: Choose the patients whose triglycerides is higher than2.26mmol/L,diagnosised of coronary heart disease and oronary heart diseasewith diabetes,who are hospitalized at the Second Hospital of Hebei MedicalUniversity during2013.01to2013.12. In each group,there are60cases.Thepatients in the two groups will be divided into two groups randomlyseperately,30patients in each group,Group A1(conventional lipid-loweringgroup):given atorvastatin20mg per night;Group A2(combined lipid-loweringgroup):given atorvastatin20mg per night and JZTLRJN2capsules there timesa day.Group B1(conventional lipid-lowering group):given atorvastatin20mgper night; Group B2(combined lipid-lowering group):given atorvastatin20mgper night and JZTLRJN2capsules there times a day. Take all the enrolledpatients’ morning fasting venous blood before treatment and two hours andfour hours after the high-fat meal.Determine the levels of lipids, liver functionindicators,and compare them within each group or during different groups.The experimental data will be obtained using SPSS18.0software forstatistical analysis,"P<0.05" is considered statistically significant. Continuousvariables are expressed as the arithmetic mean and standard deviation (X±SD),T test are used to compare the Continuous variables between two groups, Ftest are used to compare the Continuous variables between multiple groups.Discrete variables are expressed as percentage and compared with the X2test.Result:1.There is no significant differences of sex ratio, age, body mass index,smoking rates, alcohol drinking, blood pressure among all the patients.2.The changs of all the laboratory indicators2.1Comparison of lipids level among the groups before and after thetreatment2.1.1The changes of TGBefore the treatment:①Comparison inside each group: The TG level inthe coronary heart disease and type2diabetes(CHD&T2DM)group(3.16±0.64) is significantly higher than it in the coronary heart disease(CHD) group(2.86±0.62)at0h.The difference is statistically significant(P<0.05).Compared with the TG level at0h,it’s higher at2h and4h in bothCHD group and CHD&T2DM group(P<0.05),what’s more, the4hPostprandial TG elevation(CHD group4.09±1.42、CHD&T2DM group4.69±1.2) is more significant(P<0.05);②Comparison between groups:the TGlevel in CHD group is significantly lower than it in CHD&T2DM group at2hand4h after the high-fat meal(P<0.05).③Both△TG2h and△TG4h showthat CHD group is lower than CHD&T2DM group,TG2h： CHDgroup(0.63±0.220.66±0.21);CHD&T2DM group(0.87±0.300.91±0.35);△T G4h:CHD group(1.23±0.261.25±0.28)； CHD&T2DMgroup(1.58±0.261.50±0.30)(P＜0.05).That is to say,the lipid metabolism isworse in group B,and the postprandial lipid level rises more higher.After the treatment:①Comparison inside each group: we findthat,compared with the TG level at4h before the treatment，CHD conventionallipid-lowering group(4.05±1.453.69±1.26)；CHD combined lipid-loweringgroup(4.12±1.42.33±1.19);CHD&T2DM conventional lipid-loweringgroup(4.75±1.184.22±0.98);CHD&T2DM combined lipid-loweringgroup(4.63±1.243.72±1.01).it’s significantly deceased after thetreatment(P<0.05).②Comparison between groups:CHD conventionallipid-lowering group(0h2.68±0.592h3.21±0.764h3.69±1.26)>CHDcombined lipid-lowering group(0h2.16±0.532h2.50±0.684h2.33±1.19),CHD&T2DM conventional lipid-lowering group(0h3.01±0.562h3.80±0.744h4.22±0.98)>CHD&T2DM combined lipid-lowering group(0h2.76±0.582h3.35±0.714h3.72±1.01), The difference is statisticallysignificant (P<0.05);③The numerical difference comparison inside eachgroup:there is no statistical significance of△TG2hin CHD conventionallipid-lowering group (0.63±0.220.53±0.19)and CHD&T2DM conventionallipid-lowering group(0.87±0.300.79±0.17)(P<0.05),but CHD combinedlipid-lowering group (0.66±0.210.34±0.14)and CHD&T2DM combinedlipid-lowering group(0.91±0.350.59±0.15)show the opposite side(P<0.05);allof CHD conventional lipid-lowering group(1.23±0.261.01±0.19)CHD combined lipid-lowering group(1.25±0.280.71±0.21) CHD&T2DMconventional lipid-lowering group(1.58±0.26、1.21±0.21) CHD&T2DMcombined lipid-lowering group(1.50±0.300.96±0.24) have statisticalsignificance of△T G4h(P<0.05);④The numerical difference comparisonbetween groups:the TG numerical difference level shows CHD conventionallipid-lowering group<CHD&T2DM conventional lipid-lowering group,CHDcombined lipid-lowering group<CHD&T2DM combined lipid-loweringgroup in△TG2h and△T G4hbefore and after the treatment; it also showsCHD conventional lipid-lowering group<CHD&T2DM conventionallipid-lowering group,CHD combined lipid-lowering group<CHD&T2DMcombined lipid-lowering group in△TG2h after the treatment;what’s more,wefind CHD conventional lipid-lowering group<CHD&T2DM conventionallipid-lowering group,CHD combined lipid-lowering group<CHD&T2DMcombined lipid-lowering group,CHD conventional lipid-lowering group>CHDcombined lipid-lowering group,CHD&T2DM conventional lipid-loweringgroup>CHD&T2DM combined lipid-lowering group in△TG4h after thetreatment(P<0.05).2.1.2The changes of TCComparison inside each group:compared with the TC level before thetreatment,CHD conventional lipid-lowering group(5.19±0.744.34±0.50),CHDcombined lipid-lowering group(5.23±0.683.69±0.48),CHD&T2DMconventional lipid-lowering group(5.70±0.885.04±0.39),CHD&T2DMcombined lipid-lowering group(5.72±1.024.59±0.58)it significantlydecreased(P<0.05).comparison between groups: The TC level shows:CHD&T2DMconventional lipid-lowering group(5.04±0.39)>CHD conventionallipid-lowering group(4.34±0.50),CHD&T2DM combined lipid-loweringgroup(4.59±0.58)>CHD combined lipid-lowering group(3.69±0.48),CHDconventional lipid-lowering group(4.34±0.50)>CHD combined lipid-loweringgroup(3.69±0.48),CHD&T2DM conventional lipid-loweringgroup(5.04±0.39)>CHD&T2DM combined lipid-lowering group(4.59±0.58), and the difference is statistically significant (P<0.05).2.2Drug safetyThere is no ALT difference among all groups,CHD conventionallipid-lowering group(27.27±7.31) CHD combined lipid-loweringgroup(27.01±6.88) CHD&T2DM conventional lipid-loweringgroup(26.98±7.30) CHD&T2DM combined lipid-loweringgroup(27.11±6.91). ALT concentration (U/L) of different groups showed CHDconventional lipid-lowering group>CHD combined lipid-lowering group,CHD&2DM conventional lipid-lowering group>CHD&T2DM combinedlipid-lowering group6weeks later,so we find that the ALT risen level of CHDconventional lipid-lowering group and CHD&T2DM conventionallipid-lowering group were higher than CHD combined lipid-lowering groupand CHD&T2DM combined lipid-lowering group (P<0.05);CHDconventional lipid-lowering group and CHD&T2DM conventionallipid-lowering group rised equally(P>0.05); CHD combined lipid-loweringgroup and CHD&T2DM combined lipid-lowering group risedequally(P>0.05).Conclusion:Atorvastatin combined with JZTLRJN can regulate the lipidlevel,especially the postprandial triglycerides,better.As a result,it brings thepatient more benefit. At the same time, the therapy Atorvastatin combinedwith JZTLRJN is proved to be safe.