瑞舒伐他汀对急性冠脉综合征患者支架置入术后再狭窄的影响  

Influence of rosuvastatin on restenosis after stent implantation and in patients with acute coronary syndrome

作　　者：韩宝华[1] 罗晓婷[2] Han Baohua;Luo Xiaoting(Department of Cardiology, Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China)

机构地区：[1]陕西中医药大学第二附属医院心内科,咸阳712000 [2]陕西中医药大学第二附属医院重症科,咸阳712000

出　　处：《中国循证心血管医学杂志》2017年第7期842-844,847,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析瑞舒伐他汀对急性冠脉综合征患者支架置入术后再狭窄的影响及可能机制。方法纳入2015年1月~2016年3月于陕西中医药大学第二附属医院诊治的急性冠脉综合征患者110例,其中男性57例,女性53例。根据手术顺序随机分为观察组和对照组,每组各55例。对照组在常规治疗的基础上术前加用阿托伐他汀钙片,观察组在常规治疗的基础上术前加用瑞舒伐他汀,术后均连续治疗6个月。于术前和术后48 h采用酶联免疫吸附法检测血清高敏C反应蛋白(hs-CRP)、白介素-35(IL-35)、心肌肌钙蛋白I(cTnI)的水平。于术前、术后即刻和术后6个月时行冠状动脉造影检查,计算术后6个月时的净获得内径、晚期丢失内径、支架内再狭窄的发生率,统计术后6个月内不良心血管事件发生情况。结果术后6个月时,观察组支架内再狭窄发生率与对照组比较,差异无统计学意义(P>0.05)。术后即刻和术后6个月,两组患者的病变血管狭窄程度均显著低于术前,差异有统计学意义(P均<0.05)。术后6个月时,观察组的病变血管狭窄程度和晚期丢失内径低于对照组,净获得内径高于对照组,差异有统计学意义(P均<0.05)。术后6个月内,与对照组比较,观察组不良心血管事件发生率显著降低(18.2%vs.5.5%),差异有统计学意义(P<0.05)。与术前比较,术后两组患者血清hs-CRP、IL-35、cTnI水平均升高,差异有统计学意义(P均<0.05)。观察组术后的hs-CRP和cTnI水平显著低于对照组,IL-35水平显著高于对照组,差异有统计学意义(P均<0.05)。结论瑞舒伐他汀对急性冠脉综合征患者支架置入术后再狭窄发生率的影响与阿托伐他汀相当,但可显著改善患者的冠状动脉狭窄情况,降低不良心血管事件发生率,其作用机制可能与抑制高敏C反应蛋白和促进白介素-35表达有关。Objective To analyze the influence of rosuvastatin on restenosis after stent implantation and inpatients with acute coronary syndrome(ACS)and possible mechanism.Methods ACS patients(n=110,male57and female53)were chosen from the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from Jan.2015to Mar.2016,and divided randomly,according to the operation order,into observation group and control group(each n=55).The control group was given routine therapy and additional atorvastatin calcium,and observationgroup was given additional rosuvastatin besides of routine therapy for continuous6months.The levels of serumhigh-sensitivity C-reactive protein(hs-CRP),interleukin-35(IL-35)and cardiac troponin I(cTnI)were detectedby using enzyme-linked immunosorbent assay(ELISA)before and48h after the operation.All groups were givenexamination of coronary angiography before,immediately and6months after the operation for calculating net gain ofluminal diameter and late luminal loss(LLL)and observing incidence of in-stent restenosis after the operation for6months,and counting incidence of major adverse cardiovascular events(MACE)within6months after the operation.Results The difference in incidence of in-stent restenosis had no statistical significance between2groups afterthe operation for6months(P>0.05).The degree of lesion vessel stenosis was significantly lower in2groupsimmediately and6months after the operation compared with that before the operation(all P<0.05).The degree oflesion vessel stenosis and LLL were lower,and net gain of luminal diameter was higher in observation group thanthose in control group after the operation for6months(all P<0.05).The incidence of MACE decreased significantlyin observation group compared with control group(18.2%vs.5.5%)within6months after the operation(P<0.05).The levels of serum hs-CRP,IL-35and cTnI increased in2groups after the operation(all P<0.05).The levelsof hs-CRP and cTnI was significantly lower,and level of IL-35was significantly higher in observation group thanthose in c

关 键 词：急性冠脉综合征 支架置入术 再狭窄 瑞舒伐他汀 hs-CRP IL-35 

分 类 号：R541.4[医药卫生—心血管疾病]