强化剂量阿托伐他汀对急性心肌梗死患者PCI后血清单核细胞趋化蛋白-1、骨桥蛋白水平变化的影响

摘要

目的 探讨强化剂量阿托伐他汀对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后血清单核细胞趋化蛋白-1(MCP-1)、骨桥蛋白(OPN)水平变化的影响.方法 选取河北省张家口市建国医院于2016年1月至2017年3月的AMI患者82例,用随机数字表法分为阿托伐他汀常规剂量组与阿托伐他汀强化剂量组.检测AMI患者PCI前后的血清OPN、MCP-1和血脂水平,并随访AMI患者PCI后6个月不良心血管事件的发生情况.结果 术后1 d、术后1周、术后2周、术后4周两组血清OPN及MCP-1水平较术前增高,但强化剂量组各时期血清OPN及MCP-1水平低于常规剂量组(P＜0.05);疗程结束后两组低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)水平较治疗前降低,高密度脂蛋白胆固醇(HDL-C)水平较治疗前增高,且强化剂量组LDL-C、TG、TC水平低于常规剂量组,HDL-C水平高于常规剂量组(P＜0.05);疗程结束后两组左室射血分数较治疗前增高,且强化剂量组高于常规剂量组(P＜0.05);强化剂量组不良心血管事件发生率低于常规剂量组(4.88% vs. 19.51%,P＜0.05).结论 采取强化剂量阿托伐他汀对采取PCI的AMI患者予以治疗,可抑制血清MCP-1、OPN水平增高,调节血脂含量,且可改善患者心功能,降低不良心血管事件发生风险.%Objective To investigate the influence of atorvastatin in intensive dose on level changes of serum monocyte chemoattractant protein-1 (MCP-1) and osteopontin (OPN) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods AMI patients (n=82) were chosen from Jianguo Hospital of Zhangjiakou City in Hebei Province from Jan. 2016 to Mar. 2017, and divided, according to random digital table, into routine dose of atorvastatin group (routine group) and intensive dose of atorvastatin group (intensive dose group). The levels of serum OPN, MCP-1 and blood fat were detected before and after PCI in 2 groups, and incidence of major adverse cardiovascular events (MACE) was followed up after 6 months. Results The levels of serum OPN and MCP-1 increased after PCI for 1 d, 1 week, 2 weeks and 4 weeks in 2 groups, and levels of serum OPN and MCP-1 were lower in intensive dose group than those in routine group (P<0.05) at all time points. The levels of LDL-C, TG and TC decreased and level of HDL-C increased in 2 groups after treatment, and levels of LDL-C, TG and TC were lower and level of HDL-C was higher in intensive dose group than those in routine group (P<0.05). LVEF increased in 2 groups after treatment, and was higher in intensive dose group than that in routine group (P<0.05). The incidence of MACE was lower in intensive dose group than that in routine group (4.88% vs. 19.51%, P<0.05). Conclusion Atorvastatin in intensive dose can inhibit the increase of serum MCP-1 and OPN levels, regulate blood fat level, improve heart function and reduce risk of MACE in AMI patients undergone PCI.