替格瑞洛联合阿托伐他汀对冠心病不稳定心绞痛患者的VEGF、TIMP-1及炎症指标水平的影响  

Effects of ticagrelor combined with atorvastatin on the levels of VEGF, TIMP-1, and inflammatory markers in patients with unstable angina pectoris of coronary heart disease

作　　者：王瑜硕 白洁[1] 毛文娟[1] 李宝芸 WANG Yu-shuo;BAI Jie;MAO Wen-juan;LI Bao-yun(Department of Cardiology,Jintai Hospital of Baoji City,Baoji 721001,Shaanxi,CHINA;Functional department,Baoji Central Hospital,Baoji 721008,Shaanxi,CHINA)

机构地区：[1]宝鸡市金台医院心内科,陕西宝鸡721001 [2]宝鸡市中心医院功能科,陕西宝鸡721008

出　　处：《海南医学》2019年第24期3169-3172,共4页Hainan Medical Journal

摘　　要：目的探讨替格瑞洛联合阿托伐他汀对冠心病不稳心绞痛患者血管内皮生长因子(VEGF)、基质金属蛋白酶抑制物-1(TIMP-1)及炎症指标的影响。方法选取2016年7月至2018年4月在宝鸡市金台医院心内科接受治疗的冠心病不稳定心绞痛患者90例,采用随机数表法分为对照组和观察组,每组45例。对照组接受阿托伐他汀+氯吡格雷治疗,观察组接受阿托伐他汀+替格瑞洛治疗,治疗1个月。比较两组患者治疗前后的C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、亲环素A(CypA)、左心室射血分数(LVEF)、左心室舒张末期半径(LVEDD)、TIMP-1、VEGF变化,记录两组患者不良事件发生率。结果治疗后,两组患者的CRP、TNF-α、IL-6、CypA水平均降低,且观察组[(10.12±2.18)mg/mL、(3.78±0.45)ng/mL、(12.12±2.74)ng/mL、(7.02±1.02)ng/mL]明显低于对照组[(13.45±2.58)mg/mL、(4.65±0.53)ng/mL、(15.45±3.02)ng/mL、(9.03±1.23)ng/mL],差异均有统计学意义(P<0.05);治疗后,两组患者的LVEF水平均升高,观察组为(58.12±5.17)%,明显高于对照组的(50.45±5.28)%,LVEDD均降低,观察组为(40.12±3.78)mm,明显低于对照组的(44.29±4.07)mm,差异均有统计学意义(P<0.05);治疗后,两组患者的TIMP-1、VEGF均升高,且观察组分别为(538.23±13.25)ng/mL、(142.23±10.41)ng/L,明显高于对照组的(498.12±14.02)ng/mL、(112.02±13.02)ng/L,差异均有统计学意义(P<0.05);观察组患者的不良事件总发生率为8.88%,明显低于对照组的24.44%,差异有统计学意义(P<0.05)。结论阿托伐他汀联合替格瑞洛治疗冠心病不稳定心绞痛可有效降低炎症因子水平表达,促进心功能恢复,改善VEGF、TIMP-1水平表达,不良事件发生率低,值得临床推广使用。Objective To investigate the effects of ticagrelor combined with atorvastatin on vascular endothelial growth factor(VEGF),matrix metalloproteinase inhibitor-1(TIMP-1),and inflammatory markers in patients with unstable angina pectoris of coronary heart disease.Methods Ninety patients with unstable angina pectoris of coronary heart disease who were treated in the Department of Cardiology,Jintai hospital of Baoji City from July 2016 to April 2018 were divided into control group and observation group by random number table method,with 45 patients in each group.The control group was treated with atorvastatin and clopidogrel,and the observation group was treated with atorvastatin and tegrilol for one month.The changes of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),cyclophilin A(CyPA),left ventricular ejection fraction(LVEF),left ventricular end diastolic radius(LVEDD),TIMP-1,and VEGF were compared before and after treatment,and the incidence of adverse events was recorded.Results After treatment,the levels of CRP,TNF-α,IL-6,and CypA were all decreased in the two groups,and the levels were significantly lower in the observation group than in the control group:(10.12±2.18)mg/mL vs(13.45±2.58)mg/mL,(3.78±0.45)ng/mL vs(4.65±0.53)ng/mL,(12.12±2.74)ng/mL vs(15.45±3.02)ng/mL,(7.02±1.02)ng/mL vs(9.03±1.23)ng/mL;P<0.05.After treatment,the LVEF levels of the two groups were increased,and the level in the observation group was significantly higher than that in the control group:(58.12±5.17)%vs(50.45±5.28)%,P<0.05;the LVEDD levels were decreased in the two groups,and the level in the observation group was significantly lower:(40.12±3.78)mm vs(44.29±4.07)mm,P<0.05.After treatment,TIMP-1 and VEGF were elevated in both groups,and the levels in the observation group were significantly higher:(538.23±13.25)ng/mL vs(498.12±14.02)ng/mL,P<0.05;(142.23±10.41)ng/L vs(112.02±13.02)ng/L,P<0.05.The total incidence of adverse events in the observation group was 8.88%,significantly lower than 24.

关 键 词：冠心病 不稳定心绞痛 替格瑞洛 阿托伐他汀 血管内皮生长因子 基质金属蛋白酶抑制物-1 

分 类 号：R541.4[医药卫生—心血管疾病]