强化阿托伐他汀联合法舒地尔治疗冠状动脉慢血流患者的临床效果  

Effect of high-dose atorvastatin with fasudil in the treatment of patients with coronary slow flow

作　　者：李立卓[1] 郑梅[2] 彭文华[3] 赵清珍[1] 刘刚[1] 刘超[1] LI Li-zhuo;ZHENG Mei;PENG Wen-hua;ZHAO Qing-zhen;LIU Gang;LIU Chao(The First Department of Cardiology,The First Hospital of Hebei Medical University,Shijiazhuang 050031,China;The Third Department of Cardiology,The First Hospital of Shijiazhuang City,Shijiazhuang 050011,China;Department of Cardiology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]河北医科大学第一医院心内一科,石家庄050031 [2]石家庄市第一医院心内三科,石家庄050011 [3]中日友好医院心内科,北京100029

出　　处：《岭南心血管病杂志》2020年第5期499-502,共4页South China Journal of Cardiovascular Diseases

基　　金：河北省医学科学研究重点课题计划(项目编号:20170482)。

摘　　要：目的观察强化阿托伐他汀联合法舒地尔治疗冠状动脉慢血流现象(coronary slow flow,CSF)患者的临床效果。方法选择2016年8月至2018年1月在河北医科大学第一医院心内科因胸痛就诊,经冠状动脉造影诊断为CSF的患者72例为研究对象。患者按随机数字表法分为强化他汀组(n=36)和联合用药组(n=36)。强化他汀组给予阿托伐他汀40 mg/晚;联合用药组给予阿托伐他汀40 mg/晚,法舒地尔60 mg/d(14 d)静脉注射。6个月后复查冠状动脉造影再次评估冠状动脉血流状态。检测及比较治疗前、后血清三酰甘油(triacylg⁃lycerol,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)及高敏C-反应蛋白(high-sensitivity C reactive protein,hs-CRP)、肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白细胞介素-1(interleukin-1,IL-1),一氧化氮(nitric oxide,NO)浓度。结果治疗6个月后强化他汀组及联合用药组患者各支冠状动脉血流速度均优于治疗前,差异有统计学意义(P<0.05);并且联合用药组各支冠状动脉血流速度改善优于强化他汀组,差异有统计学意义(P<0.05)。与治疗前比较,联合用药组治疗后与强化他汀组患者治疗后血清TC、TG、LDL-C、hs-CRP、TNF-α、IL-1浓度均明显降低,而NO浓度明显升高,差异有统计学意义(P<0.05)。治疗后,联合用药组患者血清TC、TG、LDL-C浓度与强化他汀组治疗比较,差异无统计学意义(P>0.05),而联合用药组患者血清hs-CRP及TNF-α、IL-1浓度明显低于强化他汀组,NO浓度明显升高,差异有统计学意义(P<0.05)。结论强化阿托伐他汀联合法舒地尔可通过抑制炎症反应、改善内皮功能进而改善CSF,效果优于单独应用强化阿托伐他汀。Objectives To observe the therapeutic effects of high dose atorvastatin combined with fasudil in the treatment of patients with coronary slow flow(CSF).Methods A total of 72 patients with CSF and chest pain were randomly divided into 2 groups.Patients in high-dose group(n=36)were treated with atorvastatin 40 mg/night.Patients in combined therapy group(n=36)were treated with atorvastatin 40 mg/night and fasudil 60 mg/d intravenous drip.All the patients were treated for 6 months.After 6 months,the coronary flow velocity were measured by angiography.Serum concentrations of triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),high-sensitivity C reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),nitric oxide(NO)of all the patients were detected and compared before and after treatment.Results After 6 months,the coronary flow velocity in all the three coronaries of both high-dose statin group and combined therapy group was significantly improved(P<0.05).Improvement in combined therapy group was more significantly than that in high-dose statin group(P<0.05).Compared with before treatment,serum concentrations of TC,TG,LDL-C,hs-CRP,TNF-α,IL-1 signif⁃icantly decreased(P<0.05),but serum concentration of NO increased(P<0.05)in both the two groups after treatment.There were no significant differences of serum concentrations of TC,TG and LDL-C between the two groups after treatment(P>0.05).While serum concentrations of hs-CRP,TNF-α,IL-1 decreased significantly(P<0.05),and con⁃centrations of NO elevated significantly(P<0.05)in combined therapy group when compared with those in high-dose group after treatment.Conclusions Combination of high dose atorvastatin and fasudil can both inhibit the inflammato⁃ry response and improve the endothelial function.Then it was effective for the patients with CSF.The efficacy of com⁃bined therapy was superior to the high dose statin alone.

关 键 词：冠状动脉慢血流 法舒地尔 阿托伐他汀 

分 类 号：R541.4[医药卫生—心血管疾病]