伐尼克兰对尼古丁依赖的急性冠状动脉综合征患者血浆炎性细胞因子影响的研究  

Impact of Varenicline on Plasma Inflammatory Factor Releasing in Acute Coronary Syndrome Patients With Nicotine Dependence

作　　者：陈希伟[1] 梁雅[1] 梁德明[1] 李彪[1] 何芸[1] 赵强[1] 蔡玉华[1] 韦建瑞[1] 

机构地区：[1]广州市红十字会医院心血管医学部,广东省510220

出　　处：《中国循环杂志》2015年第12期1161-1165,共5页Chinese Circulation Journal

基　　金：广东省科技厅2011年立项课题(2011A030400013)

摘　　要：目的：观察应用酒石酸伐尼克兰干预尼古丁依赖的急性冠状动脉综合征（ACS）患者戒断烟草依赖后血管内皮功能和炎性细胞因子的变化情况，了解药物戒断治疗对尼古丁依赖的ACS患者血管内皮功能和炎性细胞因子的影响。方法：入选在本院心血管内科住院、吸烟超过10支／d、吸烟10年以上、中度及中度以上尼古丁依赖的ACS确诊患者，随机分为药物戒断组（入院后即给予口服酒石酸伐尼克兰）和干戒组（不应用药物辅助戒断），维持治疗2周，均配合每日10-30min的宣教及戒烟咨询。入选时采集全部患者的基线水平，同时留血标本检测一氧化氮（NO）、白细胞介素-6（IL-6）和内皮素-1（ET-1冰平，治疗2周后复测。结果：共入选104例符合入选标准的ACS患者，药物戒断组和干戒组各52例。治疗后，两组患者的ET-1水平[药物戒断组：（33．950±1．439）ng/L vs（170．198±12．602）ng／L；干戒组：（60．795±7．036）ng／L vs（170．511±12．374）ng／L]以及药物戒断组的IL-6水平[（0．103±0．020）ng／L vs（0．307±0．051）ng/L]均较治疗前显著降低，差异有统计学意义（P〈0．05）；两组患者治疗后的NO水平较治疗前稍降低，但差异均无统计学意义（P〉0．05）。治疗后，药物戒断组患者的ET-1[（33．950±1．439）ng／L vs（60．795±7．036）ng／L]及IL-6水平[（0．103±0．020）ng／L vs（0．258±0．042）ng／L]较干戒组明显下降，差异有统计学意义（P〈0．05），但NO水平的组间差异无统计学意义（P〉0．05）。结论：本研究提示，与不用药干戒相比，应用酒石酸伐尼克兰戒断可以有效地抑制尼古丁依赖ACS患者血浆细胞炎性因子的释放，并改善患者血管内皮功能，对患者有心血管保护作用。Objective： To observe the impact of vareniline tartrate on vascular endothelial function and inflammatory factor releasing in acute coronary syndrome （ACS） patients with nicotine dependence after smoking withdrawal treatment. Methods： We recruited the in-hospital ACS patients who were smoking 〉10 cigarettes/day for more than 10 years with at least moderate nicotine dependence, and randomly divided them into 2 groups： Varenicline group, the patients received oral medication for 2 weeks and Sel：f withdrawal group, the patients without medication assistance, n=52 in each group. All patients received （10-30） min daily mission and consulting for quit smoking for 2 weeks. The basic information was recorded and blood levels of NO, IL-6 and ET-1 were compared before and after withdrawal treatment. Results： Compared with they were before, after 2 weeks withdrawal treatment, in Varenicline group, blood levels of ET-1 decreased as （33.950 ± 1.439） ng/L vs （170.198 ± 12.602） ng/L and IL-6 decreased as （0.103 ± 0.020） ng/L vs （0.307±0.051） ng/L; in Self withdrawal group, ET-1 decreased as （60.795±7.036） ng/L vs （170.511 ± 12.374） ng/L, all P〈0.05; while NO levels were similar, P〉0.05. After treatment, ET-1 level in Varenicline group （33.950±1.439） ng/L was lower than Self withdrawal group （60.795 ± 7.036） ng/L and IL-6 level in Varenicline group （0.103±0.020） ng/L was also lower than Self withdrawal group （0.258 ＋ 0.042） ng/L, all P〈0.05; while NO levels were similar between 2 groups, P〉0.05. Conclusion： Compared with self withdrawal, varenicline tartrate may effectively inhibit inflammatory factor releasing in ACS patients with nicotine dependence, and therefore improve the vascular endothelial function.

关 键 词：急性冠状动脉综合征 尼古丁 吸烟戒断 

分 类 号：R54[医药卫生—心血管疾病]