摘要
目的探讨阿托伐他汀对冠心病患者血清炎症因子及血管内皮功能的影响。方法选取2017年1-12月收治于陆河县人民医院ICU的冠心病患者90例,采用随机数字表法,将入选的90例患者分为对照组和观察组,每组45例。纳入本研究的所有患者按照《冠心病合理用药指南》给予冠心病二级预防基础治疗,观察组在以上治疗基础上口服阿托伐他汀钙片40mg,1次/d,2组患者均连续治疗4w。检测2组患者内皮素1 (ET-1)、一氧化氮(NO)和超敏C反应蛋白(hsCRP)的水平。治疗结束后,对2组患者进行为期1年时间的随访,记录随访患者的不良心血管事件(包括严重心律失常、心力衰竭、心绞痛、心肌梗死等)的发生率。结果治疗前2组患者血管内皮功能指标(ET-1、NO)经比较差异无统计学意义;治疗后2组血流介导的血管扩张功能(flow-mediated dilation FMD)和NO水平明显高于治疗前,而观察组患者高于对照组。ET-1水平与FMD和NO相反,2组治疗后低于治疗前,而观察组明显低于对照组(P <0.05)。与治疗前比较,治疗后2组血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和(hsCRP)水平明显降低,而观察组明显低于对照组(P <0.05)。经1年的随访,观察组患者的心血管事件发生率(9.52%)低于对照组(16.28%),但差异无统计学意义(P>0.05)。结论阿托伐他汀可明显改善冠心病患者炎症因子水平和血管内皮功能,对病情恢复和预后作用明显,在临床上值得推广应用。
Objective To investigate the effects of atorvastatin on serum inflammatory factors and vascular endothelial function in the patients with coronary heart disease(CHD).Methods Ninety patients with CHD treated in Luhe County People′s Hospital from January 2017 to December 2017 were enrolled.The patients were divided into control and observation groups with 45 cases for each.All patients were employed with basic treatment for secondary prevention of CHD according to the Guidelines for Rational Use of Coronary Heart Disease.The observation group was administrated with oral atorvastatin calcium tablets 40 mg once daily except for the above treatment.The patients in the both groups were treated continuously for 4 weeks.The levels of endothelin-1(ET-1),nitric oxide(NO)and high-sensitivity C-reactive protein(hsCRP)were measured.After the treatment,the two groups were followed up for 1 year.The incidence of adverse cardiovascular events(severe arrhythmia,heart failure,angina,myocardial infarction)were recorded.Results Before the treatment,there were no significant differences in vascular endothelial function(ET-1,NO)between the two groups.The levels of FMD(flow-mediated dilation)and NO in the two groups were significantly higher than those before the treatment.Compared with the control group,the levels of FMD and NO in the observation group were higher than the control group.The ET-1 level was opposite to that of FMD and NO.The ET-1 level of the two groups was lower than that before the treatment.The ET-1 level of the observation group was lower than that of the control group with statistical significance(P<0.05).Compared with before the treatment,serum IL-6,TNF-αand hsCRP levels were significantly decreased in the two groups after the treatment.The levels of serum IL-6,TNF-αand hsCRP in the observation group were significantly lower than those in the control group(P<0.05).After 1 years′follow-up,the incidence of cardiovascular events(incidence rate,incidence of fatal myocardial infarction,heart failure and recurrent
作者
叶海标
谢帝标
YE Haibiao;XIE Dibiao(Department of ICU,Luhe County People′s Hospital,Guangdong Shanwei 516700,China)
出处
《新疆医科大学学报》
CAS
2019年第2期166-169,共4页
Journal of Xinjiang Medical University
基金
中山市科技计划项目(2015B1090)
关键词
阿托伐他汀
冠心病
血清炎症因子
血管内皮功能
atorvastatin
coronary heart disease(CAD)
inflammatory factor
endothelial function
