辛伐他汀对急性血栓性肺栓塞患者疗效及血高敏C反应蛋白、D-二聚体、基质金属蛋白酶-9水平的影响

摘要

目的：观察辛伐他汀对急性血栓性肺栓塞（ ATPE）患者疗效及血高敏C反应蛋白（ hs-CRP）、D-二聚体、基质金属蛋白酶-9（ MMP-9）水平的影响。方法50例ATPE患者，随机分为观察组和对照组各25例，对照组患者给予常规治疗，观察组患者在常规治疗基础上再口服辛伐他汀治疗，共治疗4周。比较两组患者的治疗效果和不良反应发生情况，以及治疗前后血hs-CRP、D-二聚体及 MMP-9水平。结果观察组治疗总有效率为92．00％，明显高于对照组的64．00％（P＜0．05）。治疗后，两组血清hs-CRP及D-二聚体水平均较前降低（P＜0．05），且治疗组比对照组更明显，血清MMP-9水平较治疗前稍降低，但差异无统计学意义（ P ＞0．05）。观察组患者仅1例发生呕血，对照组有2例发生肺泡内出血。结论在常规治疗的基础上口服辛伐他汀可以显著降低ATPE患者的血清hs-CRP及D-二聚体表达水平，治疗效果明显。%Objective To explore the effect of simvastatin on efficacy and blood levels of high sensitive C -reactive protein (hs-CRP),D-dimer and matrix metalloproteinase-9(MMP-9) in patients with acute thrombotic pulmonary embolism .Methods Fifty patients with acute pulmonary embolism were selected and divided into observation group or control group ,with 25 cases in each group .The control group received conventional treatment , alone, and the observation group was orally administered simvastatin on the basis of the conventional treatment.And the therapeutic course was 4 weeks.The efficacy,adverse affects,and the levels of hs-CRP,D-dimer,and MMP-9 before and after treatment were compared between the two groups .Results The total therapeutic effective rate of the observation group was 92.00%,higher than that of the control group (64.00%,P<0.05).After treatment,serum levels of both hs-CRP and D-dimer decreased in both groups (P<0.05),which was more obvious in the observation group (P<0.05),but no significant change in the serum MMP-9 level was observed in any group(P>0.05).Hematemesis occurred in 1 case of the observation group,and alveolar hemorrhage occurred in 2 cases of the control group.Conclusion Oral administration of simvastatin on the basis of conventional treatment can significantly reduce the expression levels of serum hs-CRP and D-dimer in the patients with acute thrombosis pulmonary embolism,and can obtain an obvious therapeutic efficacy.