经皮冠状动脉介入术前负荷剂量瑞舒伐他汀治疗对急性冠脉综合征患者血清水溶性凝集素样氧化低密度脂蛋白受体-1及左室射血分数的影响  

Effects of loading-dose rosuvastatin on serum sLOX-1 and LVEF in patients with acute coronary syndromes undergoing selected percutaneous coronary intervention

作　　者：焦云根[1,2] 刘乃丰[1] 孙晓宁[2] 张振刚[2] 

机构地区：[1]东南大学医学院,江苏南京210000 [2]扬州市第一人民医院心内科,江苏扬州225400

出　　处：《中国新药与临床杂志》2014年第8期608-612,共5页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探讨经皮冠状动脉介入术(PCI)术前给予非ST段抬高急性冠脉综合征(NSTEACS)患者负荷剂量的瑞舒伐他汀对患者血清水溶性凝集素样氧化低密度脂蛋白受体-1(sLOX-1)及左室射血分数的影响。方法将72例NSTEACS患者随机分为负荷治疗组33例和对照组39例,对照组给予PCI术前基础治疗,负荷治疗组在基础治疗同时于PCI术前12 h顿服瑞舒伐他汀20 mg,术前2 h再追加瑞舒伐他汀20 mg。所有患者于术前、术后24 h及术后30 d抽取静脉血,检测患者血清sLOX-1、高敏C反应蛋白(hs-CRP)、肌酸激酶MB(CK-MB)、心肌肌钙蛋白I(cTnI)、脑利钠肽(BNP)等水平;两组患者于术前及术后30 d通过超声心动图观察左室射血分数(LVEF)的变化。结果与术前比较,两组患者PCI术后24 h血清hs-CRP、sLOX-1均明显升高(P<0.05),心肌损伤标准物CK-MB、cTnI亦明显升高(P<0.01);但负荷治疗组hs-CRP、sLOX-1、CK-MB、cTnI升高水平显著低于对照组(P<0.05);术后30 d负荷治疗组血清hs-CRP、sLOX-1仍显著低于对照组(P<0.05)。与术前比较,两组患者血清总胆固醇及低密度脂蛋白胆固醇水平在术后24 h均未见明显变化(P>0.05),术后30 d出现显著下降(P<0.05),但两组之间比较未见显著差异。与对照组比较,负荷治疗组在术后30 d LVEF显著提高(P<0.05)。结论 NSTEACS患者PCI术前负荷剂量瑞舒伐他汀能明显减少PCI术后sLOX-1水平,减轻患者的心肌损伤及炎性反应,提高患者LVEF,且其独立于他汀类药物的调脂作用。AIM To investigate the effects of loading-dose rosuvastatin on serum levels of soluble lectin- like oxidized low-density lipoprotein receptor-1 （sLOX-1） and left ventricular ejection fraction （LVEF） in patients with non-ST segment elevation acute coronary syndromes （NSTEACS） undergoing selected percutaneous coronary intervention （PCI） . METHODS A total of 72 patients with non- ST segment elevation ACS were randomized to the group pretreated with rosuvastatin 20 mg 12 h before PCI and with a further 20 mg preprocedure dose group （n = 33） or control group treated with standard method （n = 39）. Serum levels of sLOX- 1, high sensitivity C reactive protein （hs-CRP）, creatine kinase-MB （CK-MB）, cardiac troponin I （cTnI） and brain natriuretic peptide （BNP） were measured before, 24 h and 30 d after the PCI. The levels of LVEF were also measured before and 30 d after the PCI in both groups. RESULTS Compared with before PCI, serum levels of sLOX-1 and hs-CRP of the two groups were elevated at 24 h after PCI （P 〈 0.05）, the levels of CK- MB and cTnI were also improved （P 〈 0.01）, however, the ascended values of sLOX-l, hs-CRP, CK-MB and cTnI were significantly lower in the loading-dose group than in the control group; serum levels of sLOX- 1 and hs-CRP were higher in the loading-dose group than in the control group at 30 d after PCI （P 〈 0.05）. But the levels of TC and LDL-C were not changed at 24 h after PCI （P 〉 0.05） until 30 d after PCI （P 〈 0.05）, but there were no difference between the two groups. Compared with the control group, levels of BNP decreased （P 〈 0.05） and LVEF （P 〈 0.05） increased in the loading-dose group. CONCLUSION The therapy of loading- dose rosuvastatin for patients with NSTEACS undergoing selected PCI can attenuate the increase of serum levels of sLOX- 1, and reduce myocardial injury and inflammatory reaction caused by PCI, also improved the reduce the LVEF at 30 days after PCI, and these effects are independent of t

关 键 词：瑞舒伐他汀 受体 LDL 血管成形术 经腔 经皮冠状动脉 急性冠脉综合征 每搏输出量 

分 类 号：R972.6[医药卫生—药品]