替罗非班联合阿托伐他汀治疗急性冠脉综合征合并心律失常的疗效观察  

Efficacy of tirofiban coronary injection combined with atorvastatin in treatment of acute coronary syndrome with arrhythmia

作　　者：龚鸿霞[1] 曹晓亮 龚俊平[1] Gong Hongxia;Cao Xiaoliang;Gong Junping(Department of Cardiology, Yiwu Central Hospital, Yiwu 322000, Zhejiang, China;Yiwu Public Security Bureau, Yiwu 322000, Zhejiang, China)

机构地区：[1]义乌市中心医院心内科,浙江义乌322000 [2]义乌市公安局,浙江义乌322000

出　　处：《中国中西医结合急救杂志》2018年第6期590-593,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省义乌市科技计划项目(12-3-22).

摘　　要：目的观察替罗非班联合阿托伐他汀治疗急性冠脉综合征(ACS)合并心律失常的疗效。方法选择2017年1月至2018年5月义乌市中心医院接诊的ACS合并心律失常患者92例,按随机数字表法分为对照组和研究组,每组46例。对照组实施常规治疗;研究组在对照组治疗基础上加用替罗非班冠状动脉(冠脉)注射联合阿托伐他汀药物治疗。观察两组患者治疗前后心肌损伤标志物、血脂水平、炎症因子、凋亡指标的变化及不良反应发生率。结果两组治疗后血清心肌肌钙蛋白T(cTnT)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)、C-myc水平均明显低于治疗前,且研究组治疗后均明显低于对照组〔cTnT(mg/L):1.5±0.5比3.2±1.0,CK(U/L):158.6±17.2比224.1±20.3,CK-MB(U/L):30.5±11.4比44.3±9.7,TC(mmol/L):5.0±0.8比5.6±0.5,LDL-C(mmol/L):2.0±1.0比2.7±1.3,IL-6(mg/L):86.5±15.2比131.4±16.3,hs-CRP(mg/L):4.7±3.3比7.3±3.6,C-myc:(18.2±8.1)%比(23.4±10.3)%〕,差异均有统计学意义(均P<0.05)。两组治疗后Bcl-2较治疗前明显升高,且研究组明显高于对照组〔(78.4±12.2)%比(69.3±9.7)%,P<0.05〕。两组均有6例患者出现用药不良反应,不良反应发生率比较差异无统计学意义〔13.0%(6/46)比13.0%(6/46),P>0.05〕。结论替罗非班冠脉注射联合阿托伐他汀治疗ACS合并心律失常效果显著,能减轻心肌细胞损伤,调节血脂水平,抑制炎症反应,抗心肌细胞凋亡。Objective To study the efficacy of tirofiban coronary injection combined with atorvastatin in the treatment of patients with acute coronary syndrome (ACS) and arrhythmia. Methods Ninety-two patients with ACS and arrhythmia admitted to Yiwu Central Hospital from January 2017 to May 2018 were enrolled, and they were divided into a control group and a study group by reference to random number table method, with 46 cases in each group. The patients in the control group received routine treatment; the patients in the study group were treated with tirofiban coronary injection combined with atorvastatin on the basis of the treatment in the control group. The changes of myocardial injury markers, blood lipid levels, inflammatory factors, apoptosis indicators and incidence of adverse reactions were observed before and after treatment in the two groups. Results After treatment the levels of serum cardiac troponin T (cTnT), creatine kinase (CK), CK isoenzyme (CK-MB), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP) and C-myc were significantly lower than those before treatment in the two groups, and all the levels in the study group were lower than those in the control group [cTnT (mg/L): 1.5±0.5 vs. 3.2±1.0, CK (U/L): 158.6±17.2 vs. 224.1±20.3, CK-MB (U/L): 30.5±11.4 vs. 44.3±9.7, TC (mmol/L): 5.0±0.8 vs. 5.6±0.5, LDL-C (mmol/L): 2.0±1.0 vs. 2.7±1.3, IL-6 (mg/L): 86.5±15.2 vs. 131.4±16.3, hs-CRP (mg/L): 4.7±3.3 vs. 7.3±3.6, C-myc: (18.2±8.1)% vs. (23.4±10.3)%], and all the above differences were statistically significant (all P < 0.05). After treatment, the levels of Bcl-2 in the two groups were significantly higher than those before treatment, and the level in the study group was obviously higher than that of the control group [(78.4±12.2)% vs. (69.3±9.7)%, P < 0.05]. The adverse reactions were found in 6 patients in each group, and the incidence of adverse reactions was the same in the two groups [13.0% (6/46) vs. 13.0%

关 键 词：替罗非班冠脉注射 阿托伐他汀 急性冠脉综合征 心律失常 炎症反应 心肌细胞凋亡 

分 类 号：R541.4[医药卫生—心血管疾病]