瑞舒伐他汀对冠心病患者的疗效及IL-35、NF-κB水平的影响

摘要

目的:观察瑞舒伐他汀对冠心病患者的临床疗效及白介素-35(IL-35)、核因子-κB(NF-κB)水平的影响.方法:85例冠心病患者被随机分为瑞舒伐他汀组(43例,在常规治疗基础上接受瑞舒伐他汀钙治疗)和阿托伐他汀组(42例,在常规治疗基础上接受阿托伐他汀钙治疗),疗程均为8周.测量比较两组患者治疗前后的心功能指标[心脏指数(CI),心排血量(CO),左室射血分数(LVEF)和左室舒张末期内径(LVEDd)],治疗总有效率以及血清IL-35和NF-κB水平.结果:与治疗前比较,治疗后两组的CI、CO、LVEF和IL-35水平显著升高,LVEDd和NF-κB水平显著降低(P<0.05或<0.01).与阿托伐他汀组比较,瑞舒伐他汀组治疗后CI[(3.54±0.72)L·min-1·m-2比(3.88±0.83)L·min-1·m-2],CO[(3.78±0.89)L/min比(4.94±0.96)L/min],LVEF[(56.20±9.71)%比(63.48±14.15)%]和血清IL-35[(96.26±24.33)pg/ml比(106.92±27.26)pg/ml]水平升高更显著,LVEDd[(4.71±0.89)cm比(4.36±0.75)cm]和NF-κB[(21.51±5.01)ng/ml比(18.32±5.17)ng/ml]水平降低更显著,P均<0.05.瑞舒伐他汀组临床总有效率(95.35%比76.19%)显著高于阿托伐他汀组,P<0.05.结论:瑞舒伐他汀治疗冠心病疗效较阿托伐他汀显著,其降脂外的心脏保护作用可能与调节血中炎症因子白介素-35、核因子-κB水平有关.%Objective:To observe therapeutic effect and influence of rosuvastatin on levels of interleukin (IL)-35 and nu- clear factor-κB (NF-κB)in patients with coronary heart disease (CHD).Methods:A total of 85 CHD patients were randomly divided into rosuvastatin group (n=43,received rosuvastatin calcium therapy based on routine treatment)and atorvastatin group (n=42,received atorvastatin calcium therapy based on routine treatment),both groups were treated for eight weeks all.Cardiac index (CI),cardiac output (CO),left ventricular ejection fraction (LVEF),left ventricular end-diastolic dimension (LVEDd),serum levels of IL-35 and NF-κB,and total effective rate were measured and compared be- tween two groups before and after treatment.Results:Compared with before treatment,there were significant rise in CI, CO,LVEF and IL-35 level,and significant reductions in LVEDd and NF-κB level in both groups after treatment (P<0.05 or<0.01).Compared with atorvastatin group after treatment,there were significant rise in CI [(3.54±0.72)L· min-1 ·m-2 vs.(3.88±0.83)L·min-1 ·m-2 ],CO [(3.78±0.89)L/min vs.(4.94±0.96)L/min],LVEF [(56.20 ±9.71)% vs.(63.48±14.15)%]and serum IL-35 level [(96.26±24.33)pg/ml vs.(106.92±27.26)pg/ml],and sig- nificant reductions in LVEDd [(4.71±0.89)cm vs.(4.36±0.75)cm]and NF-κB level [(21.51±5.01)ng/ml vs. (18.32± 5.17)ng/ml]in rosuvastatin group,P<0.05 all.Total effective rate of rosuvastatin group (95.35% vs. 76.19%)was significantly higher than that of atorvastatin group,P<0.05. Conclusion:Rosuvastatin possesses more sig- nificant therapeutic effect than that of atorvastatin on coronary heart disease,and its heart protection effect besides lipid lowering may be related to regulating levels of interleukin-35 and nuclear factor-κB.