瑞舒伐他汀对急性心肌梗死患者PCI术后炎症因子和血液流变学的影响

摘要

目的 探讨瑞舒伐他汀对急性心肌梗死患者经皮冠状动脉介入治疗(PCI)术后炎症因子和血液流变学的影响.方法 选择2014年8月~2016年8月新疆喀什地区第二人民医院收治的急性心肌梗死患者148例,其中男性83例,女性65例,年龄55~70岁,平均年龄(60.21±8.95)岁.将患者依据入院顺序随机分为对照组(75例)和观察组(73例).两组患者入院后根据病情给予药物治疗以及行PCI,观察组在此基础上加服瑞舒伐他汀,PCI术后连续7 d口服.检测治疗前和治疗7 d后两组的血脂,包括三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C),炎症因子包括白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及高敏C反应蛋白(hs-CRP),及血液流变学相关指标,包括纤维蛋白原(FIB)、血沉(ESR)、血浆粘度(PV)、全血低切黏度(NBL)和全血高切黏度(NBH).结果 两组治疗后较治疗前TG、TC、LDL-C及HDL-C均明显改善,其中观察组改善更明显,差异有统计学意义(P均<0.05).与治疗前比较,两组治疗后IL-6、TNF-α及hs-CRP水平均降低,观察组降低更明显,差异有统计学意义(P均<0.05).与治疗前比较,两组治疗后FIB、ESR、PV、NBL和NBH均下降,观察组较对照组下降更明显,差异有统计学意义(P均<0.05).结论瑞舒伐他汀可明显改善急性心肌梗死患者PCI术后的血脂水平,同时可抑制炎症因子水平和改善血液流变学指标.%Objective To explore the effect of resuvastatin on inflammatory factors and hemodynamics in patients with acute myocardial infarction after PCI. Methods 148 patients with acute myocardial infarction enrolled from August 2014 to August 2016 were randomly divided into control group (75 patients) and observation group (73 patients). The control group was given routine medication, the observation group was treated with resuvastatin on the basis of the control group. The changes of TG, TC, LDL-C, HDL-C, IL-6, TNF-α, hs-CRP, FIB, ESR, PV, NBL and NBH were detected before and after treatment. Result The levels of TG, TC, LDL-C and HDL-C before and after treatment in both groups were significantly improved, the difference was statistically significant (all P<0.05). Compared with those before treatment, the levels of IL-6, TNF-α and hs-CRP in both groups decreased after treatment, the difference was statistically significant (all P<0.05). Compared with those before treatment, the FIB, ESR, PV, NBL and NBH in both groups decreased after treatment, and were more decreased in the observation group than those in the control group, the difference was statistically significant (all P<0.05). Conclusion Resuvastatin can significantly improve the serum lipid level of patients with acute myocardial infarction after PCI treatment, while inhibiting serum inflammatory factor level and hemodynamic indexes.