不同剂量氟伐他汀缓释片对冠心病患者PCI术后氧化应激及炎性因子的影响  

Effects of different doses of fluvastatin sustained-release tablets on oxidative stress and inflammatory factors in patients with coronary heart disease undergoing percutaneous coronary intervention

作　　者：马志敏[1] 王国宏[1] 陈喆[1] 杨毅[1] 郑华[1] 葛兴[1] 陈波[1] MA Zhimin;WANG Guohong;CHEN Zhe;YANG Yi;ZHENG Hua;GE Xing;CHEN Bo(Deparment of Cardiovascular,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院心血管中心,100730

出　　处：《疑难病杂志》2018年第9期869-872,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：北京市卫生计生科研项目(6184139)

摘　　要：目的 观察不同剂量氟伐他汀缓释片对冠心病患者冠状动脉介入术(PCI)术后氧化应激、炎性因子的影响方法选择2014年1月—2017年1月首都医科大学附属北京同仁医院心血管中心行PCI治疗的冠心病患者294例作为研究对象,以随机数字表法分为3组,每组98例。对照组术后采取常规治疗方案;在此基础上,小剂量组加服氟伐他汀缓释片40 mg/次/d,大剂量组加服氟伐他汀缓释片80 mg/次/d。观察对比3组药物治疗前与治疗72h后氧化应激及炎性因子的变化,1年内心血管不良事件以及治疗期间药物不良反应的发生率。结果 治疗72 h后,大剂量组活性氧簇(ROS)、丙二醛(MDA)、一氧化氮(NO)、白介素-18(IL-18)、IL-6与肿瘤坏死因子-α(TNF-α)水平均低于小剂量组与对照组(F/P=34.846/0.000、32.182/0.000、11.922/0.037、78.294/0.000、23.834/0.000、82.038/0.000);大剂量组与小剂量组1年内心血管不良事件的发生率显著低于对照组(χ~2=15.397,P=0.000);而大剂量组与小剂量组对比差异亦有统计学意义(X^2=9.49,P<0.01);3组药物不良反应发生率对比差异无统计学意义(x^2=0.507,P>0.05)。结论 大剂量氟伐他汀缓释片对冠心病PCI术后患者氧化应激、炎性因子的调节作用更为确切。Objective To observe the effects of fluvastatin sustained-release tablets on oxidative stress and inflammatory factors in patients with coronary heart disease undergoing PCI. Methods Two hundred and ninety-four patients with coronary heart disease who received PCI treatment in Beijing Tongren Hospital from January 2014 to January 2017 were selected as research object. They were divide into 3 groups by the random number table method,with 98 cases in each group. The control group took routine treatment after operation,on this basis,the small dose group added fluvastatin sustained-release tablets 40 mg/times/d,and the large dose group plus fluvastatin sustained-release tablets 80 mg/times/d. The changes of oxidative stress and inflammatory factors between the 3 groups before treatment and 72 h after treatment were observed and compared. The incidence of adverse drug reactions during the treatment and the incidence of 1 years of cardiovascular adverse events were observed and compared between the 3 groups. Results 72 h after treatment,the levels of reactive oxygen species （ROS）, malondialdehyde （MDA） and nitric oxide （NO） in the high dose group were lower than those in the low dose group and the control group （ P 〈0.01）,the levels of IL-18,IL-6 and TNF-α were lower than those in low dose group and control group （ P 〈 0.01 ）. The incidence of adverse cardiovascular events in the high dose group and the low dose group was significantly lower than those in the control group for 1 years （ P 〈0.05）. There was no significant difference in the incidence of adverse cardiovascular events （ P 〉0.05）. There was no significant difference in the incidence of adverse drug reactions between the three groups （ P 〉0.05）. Conclusion High dose fluvastatin sustained release tablets is more precise for regulating oxidative stress and inflammatory factors in PCI patients with CHD,and is suitable for clinical application.

关 键 词：氟伐他汀 冠心病 冠状动脉介入术 氧化应激 炎性因子 

分 类 号：R541.4[医药卫生—心血管疾病]