小剂量利伐沙班对冠心病合并房颤患者PCI后Lp-PLA2及Apelin-12水平的影响  

Effects of low-dose rivaroxaban on the levels of Lp-PLA2 and Apelin-12 in patients with coronary heart disease and atrial fibrillation after PCI

作　　者：杨新利[1] 尚喜艳[1] 汪砚雨[1] 陈士芳[1] 郭晓凯[1] Yang Xinli;Shang Xiyan;Wang Yanyu;Chen Shifang;Guo Xiaokai(不详;Department of Cardiovascular Medicine,First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院心血管内科,洛阳471000

出　　处：《中国循证心血管医学杂志》2022年第6期693-695,703,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河南省医学科技攻关计划联合共建项目(2018020269)。

摘　　要：目的探讨小剂量利伐沙班对经皮冠状动脉介入术(PCI)后冠状动脉粥样硬化性心脏病(冠心病)合并心房颤动(房颤)患者体内脂蛋白磷脂酶A2抗体(Lp-PLA2)及血管活性物质12(Apelin-12)水平变化的影响。方法选取2017年9月至2019年9月于河南科技大学第一附属医院接受治疗的PCI合并房颤患者126例为研究对象,按照治疗方法分为对照组和研究组(每组各63例),在常规治疗的基础上,对照组患者口服华法林钠片,研究组在对照组治疗基础上口服利伐沙班片,均连续治疗4周。记录分析两组患者治疗前后血中Lp-PLA2及Apelin-12浓度水平,比较组间变化差异。结果治疗后,研究组中53例患者症状减轻,综合疗效有效率为84.12%,对照组中40例患者症状减轻,综合疗效有效率为63.50%,差异有统计学意义(P<0.05)。治疗后,研究组患者Lp-PLA2水平明显下降,Apelin-12水平明显上升,与治疗前及对照组比较,差异有统计学意义(P<0.05);治疗后,两组患者体内血清炎症因子hs-CRP及IL-6水平均明显增加,且治疗前后对照组高于研究组,差异有统计学意义(P<0.05);治疗后,两组患者均出现不同程度的不良反应症状(恶心,呕吐,胃肠道出血,疼痛等),研究组6例(9.52%),对照组17例(26.98%),差异有统计学意义(P<0.05)。结论小剂量利伐沙班有效改善PCI后冠心病合并房颤患者的综合疗效,Lp-PLA2浓度水平明显下降,Apelin-12浓度水平明显上升,血清炎症因子水平增加,不良反应发生率较低,具有一定临床价值。Objective To investigate the influence of low-dose rivaroxaban on levels of Lp-PLA2 and apelin-12 in patients with coronary heart disease(CHD)complicated by atrial fibrillation(AF)after percutaneous coronary intervention(PCI).Methods The patients with CHD complicated by AF undergone PCI(n=126)were chosen from the First Affiliated Hospital of Henan University of Science and Technology from Sept.2017 to Sept.2019,and divided,according to therapies,into control group and study group(each n=63).On the base of routine treatment,the control group was given warfarin sodium tablets and study group was orally given rivaroxaban tablets additionally for 4 weeks.The levels of Lp-PLA2 and Apelin-12 were recorded and analyzed in 2 groups before and after treatment,and difference was compared between 2 groups.Results After treatment,the symptoms were relieved in 53 cases in study group and effective rate was 84.12%,and symptoms were relieved in 40 cases in control group and effective rate was 63.50%(P<0.05).The level of Lp-PLA2 decreased significantly and level of Apelin-12 increased significantly in study group after treatment with statistical significance compared with before treatment and control group(P<0.05).After treatment,the levels of serum high sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)increased significantly in 2 groups,which were higher in control group than those in study group before and after treatment(P<0.05).After treatment,there were 6(9.52%)cases in study group and 17(26.98%)cases in control group had symptoms of adverse reactions in varying degrees(nausea,vomiting,gastrointestinal bleeding and pain,P<0.05).Conclusion Low-dose rivaroxaban can improve the comprehensive curative effect,reduce Lp-PLA2 level and raise Apelin-12 level and levels of serum inflammatory factors,and reduce incidence rate of adverse ractions in patients with CHD complicated by AF after PCI with certain clinical value.

关 键 词：小剂量利伐沙班 冠心病 经皮冠状动脉介入术 心房颤动 

分 类 号：R541.4[医药卫生—心血管疾病]