降同型半胱氨酸疗法对冠心病介入治疗后患者炎性因子水平的影响  

Influence of Hcy-lowering therapy on level of inflammatory factors in patients with coronary heart disease after percutaneous coronary intervention

作　　者：王丽娟[1] 樊华[2] 白宏兴 WANG Li-juan;FAN Hua;BAI Hong-xing(Department of Cardiology, People's Hospital of Yan'an City, Yan'an 716000, China)

机构地区：[1]陕西省延安市人民医院心内科,延安716000 [2]延安大学附属医院普三血管外科,延安716000

出　　处：《中国循证心血管医学杂志》2017年第1期78-80,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的研究降同型半胱氨酸(Hcy)疗法对冠状动脉粥样硬化性心脏病(冠心病)介入治疗后患者血清炎性因子水平的影响。方法选择2013年1月~2015年12月于延安市人民医院接受介入治疗的冠心病患者180例,随机数字表法分为观察组与对照组,每组各90例。对照组常规用药,氯吡格雷、阿司匹林、β受体阻滞剂和他汀类药物。观察组在常规用药基础上联合采用维生素B6、维生素B12和叶酸进行降Hcy治疗,两组均连续治疗半年。比较两组的炎症因子、血清Hcy、可溶性细胞间粘附因子-1、降钙素原和N末端脑钠肽前体水平的差异。结果两组的性别、年龄、体质指数(BMI)、合并症、病变血管数目及冠心病类型等一般资料比较差异无统计学意义(P>0.05);在接受半年治疗后,观察组的血清Hcy、白介素-6、C反应蛋白、可溶性细胞间粘附因子-1、降钙素原和N末端脑钠肽前体明显降低(P<0.05),且明显低于对照组(P<0.05)。结论降同型半胱氨酸疗法能有效降低冠心病介入治疗后患者血清Hcy水平,保护心肌功能,减轻全身炎症反应。Objective To study the influence of homocysteine (Hcy)-lowering therapy on level of serum inflammatory factors in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods CHD patients (n=180) undergone PCI were chosen from the People’s Hospital of Yan’an City from Jan. 2013 to Dec. 2015, and then divided randomly into observation group and control group (each n=90).The control group was treated with routine drugs, clopidogrel, aspirin, β-receptor blocker and statins, and the observation group was additionally given Vitamin B6, Vitamin B12 and folic acid for lowering Hcy for half year. The differences in levels of inflammatory factors, serum Hcy, soluble intercellular adhesion molecule-1 (ICAM-1),procalcitonin and N-terminal pro-brain natriuretic peptide (NT-proBNP) were compared between 2 groups.Results The differences in general data including sex, age, body mass index, complications, lesion vessels and CHD types had no statistical significance between 2 groups (P>0.05). After treatment for half year, the levels of serum Hcy, interleukin-6, C-reactive protein, soluble ICAM-1, procalcitonin and NT-proBNP decreased significantly in observation group (P<0.05), and were significantly lower than those in control group (P<0.05). Conclusion The Hcy-lowering therapy can effectively reduce the level of serum Hcy, protect myocardial function and relieve systemic inflammatory responses in patients with CHD after PCI.

关 键 词：同型半胱氨酸 冠心病 介入治疗 炎性因子 

分 类 号：R541.4[医药卫生—心血管疾病]