| 王新华,杨秀春,王德良,裴建行,魏淑岩.不同剂量瑞舒伐他汀用于急诊PCI患者的疗效及对Lp-PLA2、IL-6、TNF-α的影响[J].,2018,(23):4535-4538 |
| 不同剂量瑞舒伐他汀用于急诊PCI患者的疗效及对Lp-PLA2、IL-6、TNF-α的影响 |
| Curative Efficacy of Different Doses of Rosuvastatin in Treatment of Primary PCI and Its Effects on Lp-PLA2, IL-6 and TNF-α Levels |
| 投稿时间：2018-04-28 修订日期：2018-05-22 |
| DOI：10.13241/j.cnki.pmb.2018.23.032 |
| 中文关键词: 急性冠状动脉综合症 经皮冠状动脉介入术 瑞舒伐他汀 脂蛋白相关磷脂酶A2 白介素-6 肿瘤坏死因子-α |
| 英文关键词: Acute coronary syndromes Percutaneous coronary intervention Rosuvastatin Lipoprotein associated phospholipase A2 Interleukin -6 Tumor necrosis factor-α |
| 基金项目:河北省医学科学研究重点计划项目（162577-5-5） |
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| 中文摘要: |
| 摘要 目的：探讨不同剂量瑞舒伐他汀对急诊经皮冠状动脉介入术（PCI）患者疗效及脂蛋白相关磷脂酶A2（Lp-PLA2）、白介素（IL）-6、肿瘤坏死因子（TNF）-α的影响。方法：选择2014年2月至2016年2月我院接诊的120例急性冠状动脉综合症（ACS）患者，均急诊行PCI，以随机数表分为A组（n=40），B组（n=40）和C组（n=40），三组PCI术后均给予常规治疗，在此基础上，A组瑞舒伐他汀剂量10 mg，B组20 mg，C组30 mg，均1次/d，睡前服用，连续用药7 d。比较三组治疗前后心率（HR）、心功能以及Lp-PLA2、IL-6、TNF-α的变化，并随访一年，记录心血管不良事件发生率。结果：治疗后，三组HR、心功能指标、Lp-PLA2、IL-6、TNF-α较治疗前均显著改善（P＜0.05）；在HR中，C组＜B组＜A组，组间比较均具有显著差异（P＜0.05）；在左心室舒张期末内径（LVEDD）、左心室收缩期末内径（LVESD）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左室射血分数（LVEF）结果中，C组改善程度明显优于B组和A组，组间比较均具有显著差异（P＜0.05）；在Lp-PLA2、IL-6、TNF-α中，C组＜B组＜A组，组间比较均具有显著差异（P＜0.05）；随访结果显示，C组再狭窄发生率明显低于B组和A组，A组心肌梗死明显高于C组（P＜0.05），三组心源性休克、死亡率比较无显著差异（P＞0.05）。结论：在急诊PCI患者术后应用40 mg的瑞舒伐他汀效果显著，其有助于改善心功能，降低不良心血管事件发生率，其内在机制可能和降低Lp-PLA2、IL-6、TNF-α的表达相关。 |
| 英文摘要: |
| ABSTRACT Objective: To study Curative efficacy of different doses of rosuvastatin in treatment of primary percutaneous coronary intervention(PCI) and its effects on lipoprotein associated phospholipase A2(Lp-PLA2), interleukin(IL)-6 and tumor necrosis factor(TNF)-α levels levels. Methods: 120 patients of acute coronary syndromes(ACS) who received therapy from February 2014 to February 2016 in our hospital were selected, all emergency departments were PCI. According to random number table, those patients were divided into the A group(n=40), B group(n=48) and C group(n=40). The three groups received routine treatment after PCI, on this basis, A group rosuvas- tatin dose of 10 mg, A group rosuvastatin dose of 20 mg, C group rosuvastatin dose of 40 mg, 1 times /d, take before going to bed, contin- uous medication 7 d. The changes of heart rate (HR), heart function and Lp-PLA2, IL-6 and TNF-α the three groups were compared before and after treatment, the incidence of adverse cardiovascular events was recorded for a year following up. Results: After treatment, the HR, cardiac function index, Lp-PLA2, IL-6, TNF-α in three groups were significantly improved compared with before treatment(P＜0.05); in the HR, C group < B group < A group, there were significant differences between groups(P＜0.05); in the left ventricular end di- astolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular end diastolic volume (LVEDV), left ventricu- lar end systolic volume (LVESV), left ventricular ejection fraction (LVEF) results, the improvement degree of C group was better than that of B group and A group, there were significant differences between groups(P＜0.05); in the Lp-PLA2, IL-6 and TNF-α, C group < B group < A group, there were significant differences between groups(P＜0.05); follow up showed, the restenosis rate in the C group was significantly lower than that of the B group and A group, the myocardial infarction in the A group was significantly higher than that of the C group(P＜0.05), there was no significant difference in cardiogenic shock and mortality between the three groups(P＞0.05). Conclusion: 40mg of rosuvastatin is well for after primary PCI, it's can improve heart function, and it's intrinsic mechanism may be related to the re- duction of Lp-PLA2, IL-6 and TNF-α expression. |
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