CAJ | 학술논문

目的探索经皮冠状动脉介入治疗术(PCI)术前1次性不同量辛伐他汀对急性冠状动脉综合征(ACS)患者PCI术后炎症、氧化应激水平及血管内皮功能的影响.方法 ACS的患者124例,用随机双盲方法分辛伐他汀40 mg组(术前1次性口服40 mg辛伐他汀)、辛伐他汀20 mg组(术前1次性口服20 mg),每组62例患者,其余基础治疗一致.患者于术前和术后12 h后检测内皮素(ET-1)、一氧化氮(NO)、白细胞介素-10(IL-10),超敏C反应蛋白(hs-CRP)、超氧化物歧化酶( SOD)、丙二醛(MDA).结果 (1)两组患者的性别、年龄、置入支架总数等比较差异无统计学意义(均P＞0.05);(2)术后组间比较,辛伐他汀40 mg组ET-1、IL 10,hs-CRP低于辛伐他汀20 mg组,分别为(4.4±1.1)ng/L与(4.8±1.2)ng/L(t=2.03,P=0.044)、(15.O±6.3) ng/L与(18.7±9.0)ng/L(t=2.68,P=0.008)、(26.9±10.0)ng/L与(31.5±11.7) ng/L(t=2.52,P=0.022; NO 高于辛伐他汀20 mg组,分别为(51.9±10.9)μmol/L与(47.1±11.8)μmol/L(t=2.37,P=0.020);SOD、MDA两组间比较差异无统计学意义(均P＞0.05);(3)患者在出院前的肝功能、肌酶检查未见异常.结论 PCI术前给予40 mg辛伐他汀有抗炎和改善内皮功能的作用,优于20 mg辛伐他汀一次性负荷剂量.
목적 탐색경피관상동맥개입치료술(PCI)술전1차성불동량신벌타정대급성관상동맥종합정(ACS)환자PCI술후염증、양화응격수평급혈관내피공능적영향.방법 ACS적환자124례,용수궤쌍맹방법분신벌타정40 mg조(술전1차성구복40 mg신벌타정)、신벌타정20 mg조(술전1차성구복20 mg),매조62례환자,기여기출치료일치.환자우술전화술후12 h후검측내피소(ET-1)、일양화담(NO)、백세포개소-10(IL-10),초민C반응단백(hs-CRP)、초양화물기화매( SOD)、병이철(MDA).결과 (1)량조환자적성별、년령、치입지가총수등비교차이무통계학의의(균P＞0.05);(2)술후조간비교,신벌타정40 mg조ET-1、IL 10,hs-CRP저우신벌타정20 mg조,분별위(4.4±1.1)ng/L여(4.8±1.2)ng/L(t=2.03,P=0.044)、(15.O±6.3) ng/L여(18.7±9.0)ng/L(t=2.68,P=0.008)、(26.9±10.0)ng/L여(31.5±11.7) ng/L(t=2.52,P=0.022; NO 고우신벌타정20 mg조,분별위(51.9±10.9)μmol/L여(47.1±11.8)μmol/L(t=2.37,P=0.020);SOD、MDA량조간비교차이무통계학의의(균P＞0.05);(3)환자재출원전적간공능、기매검사미견이상.결론 PCI술전급여40 mg신벌타정유항염화개선내피공능적작용,우우20 mg신벌타정일차성부하제량.
Objective To explore the effects of one time loading of different doses of simvastatin before percutaneous coronary intervention (PCI)on post-PCI inflammation,oxidation stress and the endothelium function in (ACS) patients. Methods Totally 124 cases with ACS were randomly divided into two groups:high dose simvastatin group(40 mg,62 cases),low dose simvastatin group (20 mg,62 cases). Each group was given the same basic treatment. Blood samples were obtained from all the patients before and 12 h after PCI,and endothelin-1 (ET-1),nitric oxide (NO),interleukin-10(IL-10),high sensitive - C reactive protein(hs-CRP),superoxide dismutase (SOD) and malondialdehyde(MDA) were detected. Results The baseline information,distribution of sex,age,and implanted frames had no significant differences between the two groups (P＞0.05).Before PCI,the levels of ET-1,NO,IL-10,hs-CRP,SOD and MDA had no significant differences (P＞0.05) between the two groups.After PCI,ET-1,IL-10 and hs-CRP levels in simvastatin 40 mg group were significant lower while NO level was higher than in simvastatin 20 mg group[(4.4 ± 1.1)ng/L vs.(4.8±1.2)ng/L,t=2.03,P=0.044; (15.0±6.3) ng/L vs.(18.7±9.0)ng/L,t=2.68,P=0.008;(26.9±10.0)ng/L vs.(31.5± 11.7)ng/L,t=2.52,P =0.022;(51.9± 10.9)μmol/L vs.(47.1±11.8)μmol/L,t=2.37,P=0.020].There were no significant differences in MDA and SOD levels between the two groups.For safety,all the patients had no abnormality in liver and kidney function after treatment. Conclusions Compared with 20 mg simvastatin loading before PCI,the 40mg simvastatin loading may decrease the inflammatory cytokines and improve the endothelium function more effectively.