王芍,张海涛,刘朝中

• 1:空军总医院心内科
• 2:空军总医院放射介入诊疗中心

摘要(Abstract)：

目的评估阿托伐他汀钙序贯治疗对择期经皮冠状动脉介入治疗(PCI)患者的血脂及特异性炎性因子的影响,同时评估其安全性。方法 88例择期PCI患者随机分为序贯组(43例)及常规组(45例)。在用药前及用药后3 d、1个月、3个月及6个月抽取外周静脉血,用双抗体夹心酶联免疫法(ELISA)检测血清中的髓过氧化物酶(MPO)及基质金属蛋白酶9(MMP-9),同时观察总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、总胆红素(BIL)、肌酸激酶(CK)、γ-谷氨酰转肽酶(γ-GGT)等指标,分别评估两组的抗炎作用、调脂疗效和不良反应及事件的发生率,分析其组间差异。结果序贯组和对照组的TC及LDL-C在治疗后均明显下降,差异有统计学意义(P<0.05)。研究比较发现,两组TC及LDL-C的在治疗后3 d均出现明显的下降趋势(下降幅度:TC 26.6%比14%;LDL-C 36.9%比19.4%),两组间比较差异有统计学意义(P<0.05)。在治疗1个月时,两组的TC及LDL-C进一步降低,其中LDL-C组间差异有统计学意义(45.0%比26.9%,P<0.05)在第3个月及第6个月时的差异仍具有统计学意义(P<0.05)。炎性指标:两组患者的MMP-9及MPO治疗后较治疗前相比,两者差异均有统计学意义(P<0.05)。序贯组的MPO在治疗后明显降低,与治疗前比较差异有统计学意义(F=18.455,P=0.000)。然而,MPO在治疗后两组间比较差异无统计学意义(P>0.05)。两组患者的MMP-9治疗后与治疗前比较,差异均有统计学意义(序贯组:F=46.911,P=0.000;对照组:F=19.156,P=0.000)。在治疗后3 d,序贯组和试验组MMP-9组间比较,差异有统计学意义(P<0.05);在治疗后1个月、3个月及6个月的差异均有统计学意义(P<0.05)。两组患者的不良反应及不良事件发生率比较,差异无统计学意义(P>0.05)。结论序贯治疗和常规治疗均可有效降低血脂,序贯治疗的降脂效果更强。两种疗法均能有效地抑制炎症因子,序贯治疗可更有效地抑制MMP-9,可能有利于进一步稳定斑块,防止其破裂。

关键词(KeyWords)： 阿托伐他汀钙;序贯治疗;抗炎作用

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王芍,张海涛,刘朝中

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