瑞舒伐他汀对2型糖尿病合并冠心病病人PCI术后血清sLox-1、hs-CRP、TNF-α水平的影响  

The Influence of Rosuvastatin on sLox-1,hs-CRP and TNF-α in Patients with Type 2 Diabetes Mellitus and Coronary Heart Disease after PCI

作　　者：汪琦 李屏[1] 崔传义 胡娜 喻小琛 WANG Qi;LI Ping;CUI Chuanyi;HU Na;YU Xiaochen(The Central Hospital of Xiaogan,Xiaogan 432000,Hubei,China)

机构地区：[1]孝感市中心医院

出　　处：《中西医结合心脑血管病杂志》2019年第15期2254-2258,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：湖北省自然科学基金资助项目(No.2015CFB083)

摘　　要：目的评估瑞舒伐他汀术前治疗对2型糖尿病(T2DM)合并冠心病(CHD)病人经皮冠状动脉介入(PCI)术后血清可溶性凝集素样氧化型低密度脂蛋白受体1(sLox-1)、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平的影响。方法入选行PCI术的T2DM合并CHD病人98例,随机分为两组,研究组(51例)除进行常规治疗外,自入院后每晚顿服20mg瑞舒伐他汀进行预治疗,术前至少2次,并持续应用到术后3d。对照组(47例)术前采用常规治疗,在术前和术后均不服用他汀类药物进行治疗。分析两组病人术前及术后24h、30d血清sLox-1、hs-CRP、TNF-α水平。结果与术前24h相比,对照组与研究组术后24h的血清心肌肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnl)水平均显著升高(P<0.05),与术后24h相比,对照组与研究组术后30d的CK-MB、cTnl水平均显著降低(P<0.05),与对照组术后24h相比,研究组术后24h的CK-MB、cTnl水平显著降低(P<0.05);与术前24h相比,对照组与研究组术后24h的血清sLox-1、hs-CRP、TNF-α水平均显著升高(P<0.05),与术后24h相比,对照组与研究组术后30d的血清sLox-1、hs-CRP、TNF-α水平均显著降低(P<0.05),与对照组术后24h相比,研究组术后24h的血清sLox-1、hs-CRP、TNF-α水平显著降低(P<0.05),与对照组术后30d相比,研究组术后30d血清sLox-1、hs-CRP、TNF-α水平均显著降低(P<0.05)。对照组出现稳定型心绞痛、心肌梗死、心力衰竭、靶血管重建等主要不良心血管事件(MACE)的总发生率为27.66%,显著高于研究组的5.88%(P<0.05)。结论PCI术前及术后采用瑞舒伐他汀干预治疗T2DM合并CHD病人,能够降低术后24h血清sLox-1、hs-CRP、TNF-α水平,并降低CK-MB、cTnl水平,减少心肌损伤和血管炎症反应,降低MACE发生率,从而改善T2DM合并CHD病人PCI术后预后情况。Objective To explore the influence of rosuvastatin on soluble lectin like oxidized low density lipoprotein receptor 1(sLox-1),hypersensitive C-reactive protein(hs-CRP),and tumor necrosis factor-α(TNF-α)in patients with type 2 diabetes mellitus(T2DM)coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods Ninty-eight patients with T2DM and CHD were randomly divided into the study group(n=51)and the control group(n=47).The study group were given rosuvastatin on the basis of conventional treatment.The control group were given conventional treatment.sLox-1,hs-CRP,and TNF-αwere observed and compared between two groups.Results Compared with data 24 hours before surgery,CK-MB and cTnl in two groups were significantly increased after 24 h(P<0.05).Compared with data after 24 h and 30 days,CK-MB and cTnl in the study group were lower than those in the control group(P<0.05).Compared with data 24 hours before surgery,sLox-1,hs-CRP and TNF-αin the two groups were significantly increased after 24 h(P<0.05).Compared with data after 24 h and 30 days,sLox-1,hs-CRP and TNF-αin the study group were significantly lower than those in the control group(P<0.05).Total incidence of major cardiovascular adverse events(angina pectoris,myocardial infarction,heart failure,and target vessel reconstruction)of the control group was significantly higher than that of the study group(27.66%vs 5.88%,P<0.05).Conclusion Rosuvastatin can effectively reduce sLox-1,hs-CRP,CK-MB,cTnl,myocardial injury and vascular inflammation,and the incidence of adverse cardiac events,so as to improve the prognosis of patients with T2DM combined with CHD after PCI.

关 键 词：2型糖尿病 冠心病 瑞舒伐他汀 经皮冠状动脉介入治疗 可溶性凝集素样氧化型低密度脂蛋白受体1 炎症反应 

分 类 号：R587.1[医药卫生—内分泌] R255.4[医药卫生—内科学]