瑞舒伐他汀对急性非ST段抬高型心肌梗死患者血清炎症因子和短期预后的影响  

Effect of Rosuvastatin therapy on short-term prognosis and inflammatory factors in patients with acute non ST segment elevation myocardial infarction

作　　者：王立中[1,2] 曹树军[1,2] 程国杰[1,2] 王文斌[1,2] 俞晓薇[1,2] 张银[1,2] 韩兰唐[1,2] 

机构地区：[1]首都医科大学大兴医院 [2]北京市大兴区人民医院,北京102600

出　　处：《中国医药导报》2013年第15期106-108,共3页China Medical Herald

摘　　要：目的探讨瑞舒伐他汀治疗对急性非ST段抬高型心肌梗死(NSTEMI)患者血清炎症因子的抑制作用及对患者短期预后的影响。方法连续入选60例经临床诊断为NSTEMI患者,随机分为强化治疗组(30例)和常规治疗组(30例),两组患者均给予冠心病Ⅱ级预防药物治疗,在此基础上常规治疗组给予瑞舒伐他汀5 mg/d治疗,强化治疗组给予瑞舒伐他汀20 mg/d治疗。两组于治疗前和治疗后4周测定反应冠脉斑块炎症的炎症因子血清肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、高敏C反应蛋白(hs-CRP)及反应早期心功能变化的血浆N-末端脑钠肽前体(N-proBNP)浓度。治疗前和治疗后4周超声心动图测定左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)和左室射血分数(LVEF)。结果治疗4周后两组hs-CRP、TNF-α、IL-6和N-proBNP水平较治疗前明显降低(P<0.05),而强化治疗组变化更显著(P<0.01)。治疗后4周常规治疗组LVEDD、LVESD及LVEF值变化差异无统计学意义(P>0.05),而强化治疗组差异明显(P<0.05)。结论瑞舒伐他汀治疗对NSTEMI患者炎症反应具有明显抑制作用,而强化瑞舒伐他汀治疗抑制作用更强。短期强化瑞舒伐他汀治疗对患者心功能具有明显改善作用。Objective To evaluate the effects of Rosuvastatin on cardiac function and inflammatory factors in patients with acute non ST segment myocardial infarction（NSTEMI）.Methods 60 patients with NSTEMI verified by clinical features were investigated consecutively and randomly divided into routine group（30 cases） and intensive group（30 cases）.Both groups were given the treatment of class Ⅱ coronary heart disease prevention,on basis of which,routine group was given Rosuvastatin 5 mg/d,intensive group was given Rosuvastatin 20 mg/d.Concentrations of serum tumor necrosis factor α（TNF-α）,interleukin 6（IL-6）,high-sensitivity C-reactive protein（hs-CRP） and amino terminal-pro brain natriuretic peptide（N-proBNP） were examined before therapy and 4 weeks after therapy.Echocardiography was performed to test left ventricular end-diastolic dimension（LVEDD）,left ventricular end systolic diameter（LVESD） and left ventricular ejection fraction（LVEF） before therapy and 4 weeks after therapy.Results Serum levels of TNF-α,IL-6,hs-CRP and N-proBNP were significantly decreased after therapy in two groups（P 0.05）,while more significant changes were detected in intensive group（P 0.01）.Though there was increasing trend of LVEF value,no significant changes of LVEDD,LVESD and LVEF value were found in routine group 4 weeks after therapy（P 0.05）.While there was distinct significant change of LVEDD,LVESD and LVEF value in intensive group（P 0.05）.Conclusion Rosuvastatin therapy represents distinct anti-inflammation effect in patients with NSTEMI.Anti-inflammation effect is stronger by intensive Rosuvastatin therapy.Short-term intensive Rosuvastatin therapy in patients with NSTEMI is distinct to improve prog nosis of cardiac function.

关 键 词：瑞舒伐他汀 非ST段抬高型心肌梗死 炎症因子 预后 

分 类 号：R542.22[医药卫生—心血管疾病]