高压氧联合阿托伐他汀治疗对冠心病PCI术后血管内皮功能、凝血功能及炎症反应的影响  

Effects of hyperbaric oxygen combined with atorvastatin on vascular endothelial function,coagulation function,and inflammation reaction in patients with coronary heart disease after percutaneous coronary intervention

作　　者：赵沱 任园园 程涛 Zhao Tuo;Ren Yuanyuan;Cheng Tao(Department of Cardiovascular Medicine,Chang An Hospital,Xi’an 710016,China;Department of Cardiovascular Medicine,Xi’an Honghui Hospital,Xi’an 710054,China)

机构地区：[1]长安医院心血管内科,西安710016 [2]西安市红会医院心血管内科,西安710054

出　　处：《中华航海医学与高气压医学杂志》2025年第3期271-276,共6页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧联合阿托伐他汀治疗对经皮冠状动脉介入(PCI)术后冠心病患者血清炎症因子、血管内皮功能及凝血功能的影响。方法选取2021年1月至2023年12月长安医院心血管内科行PCI治疗的冠心病患者186例作为研究对象,按照随机数字表法分为对照组(n=93)和观察组(n=93)。对照组患者在常规对症治疗的基础上给予阿托伐他汀治疗,观察组在对照组治疗的基础上联合高压氧治疗。在2组患者治疗前后,采用放射免疫法检测超敏C反应蛋白(hs-CRP)、脂蛋白相关磷脂酶A_(2)(LP-PLA_(2))、肿瘤坏死因子(TNF)-α的水平;采用放射免疫法检测血清一氧化氮(NO)、内皮素-1(ET-1)及同型半胱氨酸(HCY)的水平;采用全自动血液凝血分析仪测定血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及D-二聚体(D-D)的水平。记录心功能恶化、支架内血栓、复发性心绞痛等主要心血管不良事件(MACE)的发生率。结果与治疗前比较,2组患者治疗后hs-CRP、LP-PLA_(2)、TNF-α、ET-1、HCY水平均明显降低,NO水平明显升高(均P<0.01),且治疗后观察组除NO外均明显低于对照组,NO水平明显高于对照组(均P<0.05)。与治疗前比较,2组患者治疗后血浆D-D水平明显降低,PT、TT、APTT均明显延长(均P<0.01);且治疗后观察组血浆D-D水平明显低于对照组,PT、TT、APTT水平均明显长于对照组(均P<0.05)。观察组MACE总发生率(8.60%)明显低于对照组(20.43%),差异有统计学意义(χ^(2)=5.234,P=0.022)。结论冠心病PCI术后采用高压氧联合阿托伐他汀治疗,能明显改善患者的血管内皮功能和凝血功能,降低血管炎症反应,减少MACE的发生,具有较好的临床应用价值。Objective To explore the effects of hyperbaric oxygen combined with atorvastatin on the indexes of serum inflammatory factors,vascular endothelial function,and coagulation function in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 186 patients with coronary heart disease who underwent PCI in the Department of Cardiovascular Medicine of Chang An Hospital from January 2021 to December 2023 were selected as the research subjects,and were divided into control group(n=93)and observation group(n=93),according to the random number table method.The control group was treated with atorvastatin on the basis of conventional symptomatic treatment,and the observation group was additionally treated with hyperbaric oxygen on the basis of the treatment of the control group.Before and after treatment,the levels of hypersensitive C-reactive protein(hs-CRP),lipoprotein-associated phospholipase A2(LP-PLA_(2)),and tumor necrosis factor(TNF-α)were detected by radioimmunoassay.The levels of serum nitric oxide(NO),endothelin-1(ET-1),and homocysteine(HCY)were also detected by radioimmunoassay.Plasma prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and D-dimer(D-D)levels were measured by automatic blood coagulation analyzer.The incidence of major adverse cardiovascular events(MACE)such as cardiac deterioration,stent thrombosis,and recurrent angina pectoris were recorded.Results After treatment,the levels of hs-CRP,LP-PLA2,TNF-α,ET-1,and HCY in the two groups were significantly decreased(all P<0.01),and the above indexes in the observation group were significantly lower than those in the control group after treatment(all P<0.05).After treatment,the level of NO was significantly increased(P<0.01),and the level of NO in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the plasma D-D levels in the two groups were significantly decreased,and the PT,TT,and APTT were significantly prolonged(all P<0.01).Af

关 键 词：冠心病 经皮冠状动脉介入 高压氧 阿托伐他汀 血管内皮功能 凝血功能 炎症反应 

分 类 号：R541.4[医药卫生—心血管疾病]