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瑞舒伐他汀强化治疗对急性冠脉综合征患者PCI术后血脂、炎症因子和预后的影响
The influence of blood fat,inflammatory cytokines and the prognosis after PCI on acute coronary syndrome patients who treated by rosuvastatin intensive treatment
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DOI:
作者:
张瑞英,杨栓锁,郑文权,乔增勇
Zhang Ruiying, Yang Shuansuo, Zheng Wenquan, Qiao Zengyong
作者单位:
上海市奉贤区中心医院心血管内科
Cardiology department of Central Hospital of Shanghai Fengxian District
关键词:
瑞舒伐他汀;急性冠脉综合征;经皮冠状动脉介入治疗;血脂;炎症因子;预后
rosuvastatin;Acute coronary syndrome;Percutaneous coronary intervention;blood lipid;Inflammatory cytokines;The prognosis
摘要:
目的 探讨瑞舒伐他汀强化治疗对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后血脂、炎症因子和预后的影响。方法 将120例急性冠脉综合征患者按随机数字表法分为观察组和对照组,每组60例,所有患者均按常规PCI术操作进行治疗,对照组患者入院后给予瑞舒伐他汀钙10mg/d,观察组患者入院后给予瑞舒伐他汀钙20mg/d,两组均连续治疗至术后6个月,对比观察两组患者PCI术前1d、术后1d、术后1个月、术后3个月、术后6个月血脂指标、炎症因子、主要心血管不良事件(MACE)以及药物不良反应。结果 两组患者术后TC、TG、LDL-C呈下降趋势,HDL-C呈上升趋势(P<0.05),至术后1个月开始,TC、TG、LDL-C均较术前显著降低,HDL-C显著升高(P<0.05),且观察组TC、TG、LDL-C显著低于对照组,HDL-C显著高于对照组(P<0.05);两组患者术后炎症因子hs-CRP、TNF-α、IL-6呈先上升后下降的趋势(P<0.05),与术前1d比较,两组术后1d上述指标均显著升高(P<0.05),至术后1个月开始两组上述指标均显著降低(P<0.05),且术后相同时间点观察组均显著低于对照组(P<0.05);观察组MACE发生率为5.00%,显著低于对照组的18.33%,差异有统计学意义(χ2=10.093,P=0.000); 两组患者均未出现肌痛等严重不良反应,主要不良反应为胃肠道反应且较轻微。结论 瑞舒伐他汀可能通过降低ACS患者PCI术后炎症因子,调节血脂以改善患者预后,且瑞舒伐他汀强化治疗可以使患者获益更多。
Objective: To explore the effect of rosuvastatin intensive treatment on blood lipid,inflammatory cytokines and prognosis of patients with acute coronary syndrome(ACS)after the percutaneous coronary intervention(PCI) operation. Methods: 120 cases of patients with ACS were randomly divided into the observation group and control group,each 60 cases, all patients were treated according to the conventional PCI operation, the control group was given rosuvastatin calcium 10 mg/d while the observation group was given 20mg/d doses, both two groups were continuously treated until 6 months after the PCI operation. Observed and compared two groups patients blood lipid, inflammatory cytokines, major adverse cardiovascular events (MACE) and adverse drug reactions 1d before,1d,1 month, 3 months and 6 months after PCI operation. Results: Both two groups TC, TG and LDL-C decreased while HDL-C increased after the PCI operation(P<0.05), TC, TG and LDL-C were significantly decreased while HDL-C was significantly increased 1 month after the operation(P<0.05) and the observation group TC, TG and LDL-C were significantly lower while HDL-C was significantly higher than those of the control group(P<0.05); two groups hs-CRP, TNF-α and IL-6 was first increased and then decreased(P<0.05),hs-CRP, TNF-α and IL-6 was significantly increased 1d after operation and significantly decreased 1 month after operation(P<0.05), the observation group hs-CRP, TNF-α and IL-6 were significantly lower than those of the control group(P<0.05); the observation group MACE incidence was 5.00%, that was significantly lower than 18.33% of the control group,the difference was statistically significant(χ2=10.093,P=0.000); serious adverse reactions such as muscle ache were not found in both two groups and the mainly adverse reaction was mild gastrointestinal reaction. Conclusion: Rosuvastatin can reduce the inflammatory factors, regulate blood lipid and improve the prognosis of patients with ACS after PCI operation, rosuvastatin intensive treatment can make patients benefited more than small dosage.
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