阿托伐他汀对老年心肌梗死患者心室重构及血清ICAM-1、IL-6、TNF-α表达的影响  

Effect of Atorvastatin on Ventricular Remodeling and Serum ICAM-1,IL-6 and TNF-α Expressions in Elderly Patients with Myocardial Infarction

作　　者：赵冬婧[1] 汤玮[1] 曹树军[1] 胡硕强[1] 

机构地区：[1]首都医科大学大兴医院心血管内科,北京102600

出　　处：《解放军医药杂志》2016年第3期54-58,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的研究阿托伐他汀对老年心肌梗死患者心室重构及血清细胞间黏附因子-1(intercellular cell adhesion molecule-1,ICAM-1)、白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达的影响。方法选取2013年7月—2015年7月收治的老年心肌梗死患者78例行回顾性分析,按照治疗方法不同分为观察组(39例)和对照组(39例)。观察组采取阿托伐他汀进行治疗,对照组采取氟伐他汀进行治疗。比较两组治疗前后血清ICAM-1、IL-6、TNF-α水平、心室质量及指数检测结果、血流动力学参数及心脏彩超结果等指标。结果观察组左室舒张末压低于对照组,但其左心室收缩压、等容收缩期左心室内压力上升的最大速率、等容收缩期左心室压力下降的最大速率却明显高于对照组,差异有统计学意义(P<0.01)。观察组左心室质量和左心室质量指数明显低于对照组,差异有统计学意义(P<0.01)。观察组的左心室舒张末期内径、左心室收缩末期内径、室间隔厚度值明显低于对照组,而左心室射血分数则明显高于对照组,差异有统计学意义(P<0.01)。治疗后,两组血清ICAM-1、IL-6、TNF-α、甘油三酯水平均有所降低,且观察组下降水平明显低于对照组,差异有统计学意义(P<0.05,P<0.01)。结论阿托伐他汀能有效减少患者心肌梗死面积,从而有效逆转心室重构;同时也能有效降低血清ICAM-1、IL-6及TNF-α表达,提高患者治愈率。Objective To study the effect of Atorvastatin on ventricular remodeling and serum intercellular cell adhesion molecule-1（ ICAM-1）,interleukin-6（ IL-6） and tumor necrosis factor-α（ TNF-α） expressions in elderly patients with myocardial infarction. Methods Clinical data of 78 elderly patients with myocardial infarction during July2013 and July 2015 was retrospectively analyzed,and were divided into observation group（ n = 39） and control group（ n = 39） according to different treatment methods. The observation group was treated with Atorvastatin,while the control group received Fluvastatin therapy. The serum ICAM-1,IL-6 and TNF-α levels,test results of ventricular mass and indexes,hemodynamic parameters and echocardiography results were compared before and after the treatment in the two groups. Results Compared with those in control group,in observation group,left ventricular end-diastolic pressure（ LVEDP） value was lower,but values of left ventricular systolic pressure（ LVSP）,ascending maximum speed of left intraventricular pressure during isovolumic contraction period（ ＋ Dp / dtmax） and descending maximum speed of left intraventricular pressure during isovolumic contraction period（- Dp / dtmax） were significantly higher（ P〈0. 01）. Values of left ventricular mass and left ventricular mass index（ LVMI） in the observation group were significantly lower than those in the control group（ P〈0. 01）. Compared with those in control group,in the observation group,values of left ventricular end-diastolic dimension（ LVEDD）,left ventricular end systolic diameter（ LVESD） and interventricular septum（ IVS） thickness were significantly lower,but left ventricular ejection fraction（ LVEF） value was significantly higher（ P〈0. 01）. After the treatment,the ICAM-1,IL-6,TNF-α and triglyceride levels were decreased in the two groups,and the decreased levels in the observation group were significantly lower than those in the control group（ P〈0. 05,P〈0. 01�

关 键 词：阿托伐他汀 老年心肌梗死 心室重构 细胞间黏附因子-1 白介素-6 肿瘤坏死因子-α 

分 类 号：R542.22[医药卫生—心血管疾病]