中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2012年
3期
277-281
,共5页
葛长江%吕树铮%柳弘%冯利霞%宋现涛%陈欣%孟康%苑飞%季凤清%霍勇
葛長江%呂樹錚%柳弘%馮利霞%宋現濤%陳訢%孟康%苑飛%季鳳清%霍勇
갈장강%려수쟁%류홍%풍리하%송현도%진흔%맹강%원비%계봉청%곽용
胱抑素C%冠状动脉疾病%冠状动脉临界病变
胱抑素C%冠狀動脈疾病%冠狀動脈臨界病變
광억소C%관상동맥질병%관상동맥림계병변
Cystatin C%Coronary artery disease%Borderline coronary lesion
目的 研究冠脉临界病变患者血浆胱抑素C水平(plasma cystatin C concentration,PcyC)的变化,探讨阿托伐他汀和普罗布考的联合治疗对其PcyC水平和冠脉病变严重程度的影响.方法 连续入选2006年5月至2010年11月在北京安贞医院住院经定量冠脉造影检查确诊冠脉临界病变130例(borderline coronary lesion,BCL),136例无冠脉病变的受试者纳入对照组( controls,CTR).BCL组患者被随机(随机密封信封法)分为常规治疗组(routine treatment,RTT,n =60)和联合治疗组(combined treatment,CBT,n=70),连续治疗6个月.联合治疗组除常规药物治疗外,每日加用阿托伐他汀20 mg和普罗布考1.0g.各组性别、年龄等一般资料间比较差异均无统计学意义,具有可比性.检测其血PcyC和高敏C-反应蛋白(high-sensitive C-reactive protein,hs-CRP)水平,以及总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)及甘油三酯( triglycerides,TG)浓度.其中BCL组104例受试者复查冠脉造影.两组间均数比较采用t检验和方差分析,计数资料使用X2检验,以P＜0.05为差异具有统计学意义.结果 BCL组PcyC水平明显高于CTR组(P＜0.05).与RTT组相比,CBT组PcyC水平、TC、LDL-C、TG、和hs-CRP明显降低(P＜0.05,P＜0.01).此外,治疗6个月后RTT组冠脉临界病变的平均狭窄程度(meanpercent stenosis,MPS)有所下降(P＞0.05),而CBT组却见明显减低(P＜0.05).结论 PcyC参与冠状动脉疾病的病理过程,且与冠脉病变的严重程度密切相关.阿托伐他汀和普罗布考的联合应用可降低PcyC水平,其可能是冠脉临界病变治疗的选择.
目的 研究冠脈臨界病變患者血漿胱抑素C水平(plasma cystatin C concentration,PcyC)的變化,探討阿託伐他汀和普囉佈攷的聯閤治療對其PcyC水平和冠脈病變嚴重程度的影響.方法 連續入選2006年5月至2010年11月在北京安貞醫院住院經定量冠脈造影檢查確診冠脈臨界病變130例(borderline coronary lesion,BCL),136例無冠脈病變的受試者納入對照組( controls,CTR).BCL組患者被隨機(隨機密封信封法)分為常規治療組(routine treatment,RTT,n =60)和聯閤治療組(combined treatment,CBT,n=70),連續治療6箇月.聯閤治療組除常規藥物治療外,每日加用阿託伐他汀20 mg和普囉佈攷1.0g.各組性彆、年齡等一般資料間比較差異均無統計學意義,具有可比性.檢測其血PcyC和高敏C-反應蛋白(high-sensitive C-reactive protein,hs-CRP)水平,以及總膽固醇(total cholesterol,TC)、低密度脂蛋白膽固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白膽固醇(high-density lipoprotein cholesterol,HDL-C)及甘油三酯( triglycerides,TG)濃度.其中BCL組104例受試者複查冠脈造影.兩組間均數比較採用t檢驗和方差分析,計數資料使用X2檢驗,以P＜0.05為差異具有統計學意義.結果 BCL組PcyC水平明顯高于CTR組(P＜0.05).與RTT組相比,CBT組PcyC水平、TC、LDL-C、TG、和hs-CRP明顯降低(P＜0.05,P＜0.01).此外,治療6箇月後RTT組冠脈臨界病變的平均狹窄程度(meanpercent stenosis,MPS)有所下降(P＞0.05),而CBT組卻見明顯減低(P＜0.05).結論 PcyC參與冠狀動脈疾病的病理過程,且與冠脈病變的嚴重程度密切相關.阿託伐他汀和普囉佈攷的聯閤應用可降低PcyC水平,其可能是冠脈臨界病變治療的選擇.
목적 연구관맥림계병변환자혈장광억소C수평(plasma cystatin C concentration,PcyC)적변화,탐토아탁벌타정화보라포고적연합치료대기PcyC수평화관맥병변엄중정도적영향.방법 련속입선2006년5월지2010년11월재북경안정의원주원경정량관맥조영검사학진관맥림계병변130례(borderline coronary lesion,BCL),136례무관맥병변적수시자납입대조조( controls,CTR).BCL조환자피수궤(수궤밀봉신봉법)분위상규치료조(routine treatment,RTT,n =60)화연합치료조(combined treatment,CBT,n=70),련속치료6개월.연합치료조제상규약물치료외,매일가용아탁벌타정20 mg화보라포고1.0g.각조성별、년령등일반자료간비교차이균무통계학의의,구유가비성.검측기혈PcyC화고민C-반응단백(high-sensitive C-reactive protein,hs-CRP)수평,이급총담고순(total cholesterol,TC)、저밀도지단백담고순(low-density lipoprotein cholesterol,LDL-C)、고밀도지단백담고순(high-density lipoprotein cholesterol,HDL-C)급감유삼지( triglycerides,TG)농도.기중BCL조104례수시자복사관맥조영.량조간균수비교채용t검험화방차분석,계수자료사용X2검험,이P＜0.05위차이구유통계학의의.결과 BCL조PcyC수평명현고우CTR조(P＜0.05).여RTT조상비,CBT조PcyC수평、TC、LDL-C、TG、화hs-CRP명현강저(P＜0.05,P＜0.01).차외,치료6개월후RTT조관맥림계병변적평균협착정도(meanpercent stenosis,MPS)유소하강(P＞0.05),이CBT조각견명현감저(P＜0.05).결론 PcyC삼여관상동맥질병적병리과정,차여관맥병변적엄중정도밀절상관.아탁벌타정화보라포고적연합응용가강저PcyC수평,기가능시관맥림계병변치료적선택.
Objective To study the changes of plasma cystatin C level (PcyC),and evaluate the effects of the joint use of atorvastatin and probucol on PcyC and severity of coronary lesion in patients with borderline lesion of coronary artery.Methods One hundred and thirty consecutive patients with borderline coronary lesion assessed by quantitative coronary angiography were enrolled into borderline coronary lesion group (BCL),and another 136 subjects without coronary lesion were enrolled as controls (CTR).And in the meantime,the subjects in BCL group were randomized (closed envelope method) into routine treatment subgroup ( RTT,n =60),and combined treatment subgroup in which patients were treated with atorvastatin 20 mg plus probucol 1.0 g daily in addition to routine medication ( CBT,n =70) for 6 months.There were no statistical differences in basic clinical features between two subgroups.PcyC,high-sensitive C-reactive protein (hs-CRP),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol ( HDL-C ) and triglycerides (TG) were determined.Of them,104 patients in BCL group rechecked by coronary angiography.Comparison of biomarkers carried out between two groups by using a number of independent-sample t-test and analysis of variance.For enumeration data,chi-square test was used to compare mean values of biomarkers between groups. P ＜ 0.05 was considered statistically significant.Results PcyC levels were significantly higher in BCL group than those in CTR group ( P ＜ 0.05 ).Compared with RTT subgroup,levels of PcyC,TC,LDL-C,TG and hs-CRP were more significantly decreased in CBT subgroup (P ＜ 0.05,P ＜ 0.01 ).Moreover,there was a trend of slight decrease in the mean percent of stenosis (MPS) of coronary artery with borderline lesion in RTT subgroup treated for 6 months,whereas more marked decrease in the MPS of coronary artery with borderline coronary lesion in CBT subgroup treated for 6 months ( P ＞ 0.05 ; P ＜ 0.05 ).Conclusions Cystatin C plays an important role in the pathogenesis of coronary artery,and PcyC is associated with severity of coronary lesion,the combination of atorvastatin and probucol decreases the PcyC level,and it may be the treatment of choice for borderline lesion of coronary artery.
