瑞舒伐他汀动员内皮祖细胞对心肌梗死患者心室重构的影响

摘要

To observe influence of endothelial progenitor cells (EPCs) mobilized by rosuvastatin on ven‐tricular remodeling in patients with myocardial infarction (MI).Methods : A total of 128 MI patients received PCI treated in our department from Jan 2017 to Jan 2018 were selected , randomly and equally divided into routine treat‐ment group and rosuvastatin group (received rosuvastatin based on routine treatment group ) , both groups were con‐tinuously treated for 28d .Peripheral blood percentage of EPCs before and 28d after treatment , LVEF , LVESd and LVEDd before and six months after treatment , and incidence rate of adverse reactions were measured and compared between two groups .Results : Compared with before treatment , there was significant rise in peripheral blood per‐centage of EPCs [ (0. 64 ± 0. 15)% vs.(1. 08 ± 0.23)%] in only rosuvastatin group on 28d after treatment , P＝0.001 ;and was significantly higher than that of routine treatment group [(1.08 ± 0.23)% vs.(0.58 ± 0.12)%] , P＝ 0. 001. Compared with before treatment , there was significant rise in LVEF , and significant reductions in LVEDd and LVESd in two groups on six months after treatment , P＝0.001 all ;compared with routine treatment group , there was significant rise in LVEF [ (52.24 ± 7.18)% vs.(58. 36 ± 8.62)%] , and significant reductions in LVESd [ (33.46 ± 5. 04) mm vs.(30. 26 ± 4. 15) mm] and LVEDd [ (56.17 ± 8. 24) mm vs.(51. 38 ± 7.62) mm] in rosuvastatin group , P＝0. 001 all .There was no significant difference in incidence rate of adverse reactions be‐tween two groups , P＝0. 752. Conclusion : Rosuvastatin can mobilize EPCs to inhibit ventricular remodeling , sig‐nificantly improve cardiac function with good safety in patients with myocardial infarction , which is worth exten‐ding .%目的 观察心肌梗死(MI)患者使用瑞舒伐他汀后对内皮祖细胞(EPCs)的动员作用,以及其对心室重构的影响.方法 选择2017年1月至2018年1月于我科接受PCI治疗的MI患者128例.患者被随机均分为常规治疗组和瑞舒伐他汀组(在常规治疗组基础上加用瑞舒伐他汀) ,两组均连续治疗28d .测量比较两组治疗前、 28d后的外周血EPCs比例,治疗前、结束6个月后LVEF 、左室收缩末期内径(LVESd) 、左室舒张末期内径(LVEDd)以及不良反应率.结果 与治疗前比较,治疗28d后瑞舒伐他汀组外周血EPCs比例[ (0.64 ± 0.15)% 比(1. 08 ± 0.23)%]显著升高, P＝0.001 ;且显著高于常规治疗组[ (1.08 ± 0.23)% 比(0.58 ± 0.12)%] , P＝0.001 .与治疗前比较,两组治疗结束6个月后LVEF均显著升高, LVESd和LVEDd均显著降低, P均＝0.001 ;与常规治疗组比较,瑞舒伐他汀组LVEF [(52. 24 ± 7.18)% 比(58. 36 ± 8.62)%]升高更显著, LVESd [(33. 46 ± 5.04) mm比(30.26 ± 4.15) mm]和LVEDd [ (56.17 ± 8. 24) mm比(51. 38 ± 7. 62) mm]降低更显著, P均＝0.001 .两组不良反应发生率无显著差异, P＝0.752 .结论 瑞舒伐他汀可以增加心肌梗死患者内皮祖细胞动员,抑制心室重构,显著改善心功能,使用安全,值得推广.