中国介入心脏病学杂志
中國介入心髒病學雜誌
중국개입심장병학잡지
CHINESE JOURNAL OF INTERVENTIONAL CARDIOLOGY
2014年
4期
230-236
,共7页
阿托伐他汀钙%序贯治疗%抗炎作用
阿託伐他汀鈣%序貫治療%抗炎作用
아탁벌타정개%서관치료%항염작용
Atorvastatin%Sequential therapy%Anti-inlfammatory
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。
目的:評估阿託伐他汀鈣序貫治療對擇期經皮冠狀動脈介入治療(PCI)患者的血脂及特異性炎性因子的影響,同時評估其安全性。方法88例擇期PCI患者隨機分為序貫組(43例)及常規組(45例)。在用藥前及用藥後3 d、1箇月、3箇月及6箇月抽取外週靜脈血,用雙抗體夾心酶聯免疫法(ELISA)檢測血清中的髓過氧化物酶(MPO)及基質金屬蛋白酶9(MMP-9),同時觀察總膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、穀丙轉氨酶(ALT)、總膽紅素(BIL)、肌痠激酶(CK)、γ-穀氨酰轉肽酶(γ-GGT)等指標,分彆評估兩組的抗炎作用、調脂療效和不良反應及事件的髮生率,分析其組間差異。結果序貫組和對照組的TC及LDL-C在治療後均明顯下降,差異有統計學意義(P<0.05)。研究比較髮現,兩組TC及LDL-C的在治療後3 d均齣現明顯的下降趨勢(下降幅度:TC 26.6%比14%;LDL-C 36.9%比19.4%),兩組間比較差異有統計學意義(P<0.05)。在治療1箇月時,兩組的TC及LDL-C進一步降低,其中LDL-C組間差異有統計學意義(45.0%比26.9%,P<0.05)在第3箇月及第6箇月時的差異仍具有統計學意義(P<0.05)。炎性指標:兩組患者的MMP-9及MPO治療後較治療前相比,兩者差異均有統計學意義(P<0.05)。序貫組的MPO在治療後明顯降低,與治療前比較差異有統計學意義(F=18.455,P=0.000)。然而,MPO在治療後兩組間比較差異無統計學意義(P>0.05)。兩組患者的MMP-9治療後與治療前比較,差異均有統計學意義(序貫組:F=46.911,P=0.000;對照組:F=19.156,P=0.000)。在治療後3 d,序貫組和試驗組MMP-9組間比較,差異有統計學意義(P<0.05);在治療後1箇月、3箇月及6箇月的差異均有統計學意義(P<0.05)。兩組患者的不良反應及不良事件髮生率比較,差異無統計學意義(P>0.05)。結論序貫治療和常規治療均可有效降低血脂,序貫治療的降脂效果更彊。兩種療法均能有效地抑製炎癥因子,序貫治療可更有效地抑製MMP-9,可能有利于進一步穩定斑塊,防止其破裂。
목적:평고아탁벌타정개서관치료대택기경피관상동맥개입치료(PCI)환자적혈지급특이성염성인자적영향,동시평고기안전성。방법88례택기PCI환자수궤분위서관조(43례)급상규조(45례)。재용약전급용약후3 d、1개월、3개월급6개월추취외주정맥혈,용쌍항체협심매련면역법(ELISA)검측혈청중적수과양화물매(MPO)급기질금속단백매9(MMP-9),동시관찰총담고순(TC)、삼선감유(TG)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)、곡병전안매(ALT)、총담홍소(BIL)、기산격매(CK)、γ-곡안선전태매(γ-GGT)등지표,분별평고량조적항염작용、조지료효화불량반응급사건적발생솔,분석기조간차이。결과서관조화대조조적TC급LDL-C재치료후균명현하강,차이유통계학의의(P<0.05)。연구비교발현,량조TC급LDL-C적재치료후3 d균출현명현적하강추세(하강폭도:TC 26.6%비14%;LDL-C 36.9%비19.4%),량조간비교차이유통계학의의(P<0.05)。재치료1개월시,량조적TC급LDL-C진일보강저,기중LDL-C조간차이유통계학의의(45.0%비26.9%,P<0.05)재제3개월급제6개월시적차이잉구유통계학의의(P<0.05)。염성지표:량조환자적MMP-9급MPO치료후교치료전상비,량자차이균유통계학의의(P<0.05)。서관조적MPO재치료후명현강저,여치료전비교차이유통계학의의(F=18.455,P=0.000)。연이,MPO재치료후량조간비교차이무통계학의의(P>0.05)。량조환자적MMP-9치료후여치료전비교,차이균유통계학의의(서관조:F=46.911,P=0.000;대조조:F=19.156,P=0.000)。재치료후3 d,서관조화시험조MMP-9조간비교,차이유통계학의의(P<0.05);재치료후1개월、3개월급6개월적차이균유통계학의의(P<0.05)。량조환자적불량반응급불량사건발생솔비교,차이무통계학의의(P>0.05)。결론서관치료화상규치료균가유효강저혈지,서관치료적강지효과경강。량충요법균능유효지억제염증인자,서관치료가경유효지억제MMP-9,가능유리우진일보은정반괴,방지기파렬。
Objective To assess the inlfuence and safety of early atorvastatin sequential therapy in coronary heart disease (CHD) patients underdoing elective percutaneous coronary intervention on selected indicators of inflammation and serum lipids. Methods A total of 88 CHD patients who got ready to receive the elective percutaneous coronary intervention (PCI) were divided in two groups at random:The sequential dose group was called group A (atorvatatin 80mg as loading dose ,40 mg/d for 1 month after PCI and 20 mg/d subsequently, n=43), and the ordinary dose group was called group B ( atorvastatin 20 mg/d, n=45). During the follow-up, blood samples were taken at baseline, 3 days,1 month, 3 months and 6 months for myeloperoxidase (MPO), matrix metalloproteinase-9(MMP-9), serum lipids, serum alanine aminotransferase (ALT), glutamyl endopeptidase (GGT) and creatine kinase (CK) levels. Main adverse cardiac events and adverse effects were also analyzed. Results Compared with the baseline, the level of low-density lipoprotein-cholesterol (LDL-C) and total cholesterol (TC) was signiifcantly decreased in both two groups after treatment (P < 0.05). The LDL-C and TC in both groups were all decreased after treatment, and the degree of LDL-C and TC decreased at 3 days had signiifcant differences between the two groups (TC:26.6%vs. 14.0%;LDL-C:36.9%vs. 19.4%, both P<0.05). The degree of LDL-C decreased at 1 month between the two groups also had signiifcant differences (45.0%vs. 26.9%;P<0.05). The changes in LDL-C and TC level were also signiifcantly different between the two groups at 3 and 6 months (P<0.05). While TG and HDL-C remained unchanged. MMP-9 and MPO were both reduced post medication compared to pre-treatment levels (P<0.05). MPO was decreased signiifcantly in group A after treatment (F=18.455, P=0.000). And the same differences in group B were also signiifcant (P < 0.05). MPO post medication between the 2 groups were not significantly different (P > 0.05). Reduction in MMP-9 also showed signiifcant in both groups after treatment (group A:F=46.911, P=0.00;group B:F=19.156, P=0.00). The adverse effects had no signiifcant differences between the 2 groups (P>0.05). Conclusions The atorvastatin sequential theapy in CHD patients undergoing elective percutaneous coronary intervention could decrease serum lipids signiifcantly. Pretreatment with atorvastatin for patients undergoing PCI could inhibit inlfammation. The MACE and adverse effects were similar between the two groups.