瑞舒伐他汀联合替格瑞洛对行经皮冠状动脉介入治疗的冠心病患者的影响

摘要

目的 探讨瑞舒伐他汀联合替格瑞洛对行经皮冠状动脉介入术(PCI)的冠心病患者的影响.方法 选取2014年6月-2016年6月在武警四川省总队医院行PCI的冠心病患者114例,随机分为对照组和观察组,每组57例.在常规治疗基础上,对照组患者术后予以氯吡格雷治疗,观察组患者术后予以瑞舒伐他汀联合替格瑞洛治疗;两组患者均持续治疗3个月.比较两组患者临床疗效,治疗前后血清胰岛素样生长因子Ⅰ (IGF-Ⅰ)、转化生长因子β1(TGF-β1)、基质金属蛋白酶9(MMP-9)水平,颈动脉斑块面积及内膜中层厚度(IMT),治疗后1年不良心血管事件发生情况.结果 观察组患者临床疗效优于对照组(P＜0.05).治疗前两组患者血清IGF-Ⅰ、TGF-β1、MMP-9水平比较,差异无统计学意义(P＞0.05);治疗后观察组患者血清IGF-Ⅰ、TGF-β1水平高于对照组,血清MMP-9水平低于对照组(P＜0.05).治疗前两组患者颈动脉斑块面积、IMT比较,差异无统计学意义(P＞0.05);治疗后观察组患者颈动脉斑块面积、IMT小于对照组(P＜0.05).观察组患者治疗后1年不良心血管事件发生率低于对照组(P＜0.05).结论 瑞舒伐他汀联合替格瑞洛可有效提高冠心病患者PCI后临床疗效,升高血清IGF-Ⅰ、TGF-β1水平,降低血清MMP-9水平,缩小颈动脉斑块面积,减少不良心血管事件的发生.%Objective To explore the impact of rosuvastatin combined with ticagrelor on postoperative coronary heart disease patients treated by PCI.Methods A total of 114 coronary heart disease patients undergoing PCI were selected in Sichuan Provincial General Hospital of Armed Police Force from June 2014 to June 2016,and they were randomly divided into control group and observation group,each of 57 cases.Based on conventional treatment,patients of control group received clopidogrel,while patients of observation group received rosuvastatin combined with ticagrelor;both groups continuously treated for 3 months.Clinical effect,serum levels of IGF-Ⅰ,TGF-β1 and MMP-9,carotid plaque area and IMT before and after treatment,and incidence of adverse cardiovascular events 1 year after treatment were compared between the two groups.Results Clinical effect in observation group was statistically significantly better than that of control group (P ＜0.05).No statistically significant differences of serum level of IGF-Ⅰ,TGF-β1 or MMP-9 was found between the two groups before treatment (P ＞ 0.05);after treatment,serum levels of IGF-Ⅰ and TGF-β1 in observation group were statistically higher than those in control group,while serum MMP-9 level in observation group was statistically significantly lower than that in control group (P ＜ 0.05).No statistically significant differences of carotid plaque area or IMT was found between the two groups before treatment (P ＞ 0.05),while carotid plaque area and IMT in observation group were statistically significantly smaller than those in control group after treatment (P ＜ 0.05).Incidence of adverse cardiovascular events in observation group was statistically significantly lower than that in control group 1 year after treatment (P ＜ 0.05).Conclusion Rosuvastatin combined with ticagrelor has certain clinical effect in treating postoperative coronary heart disease patients treated by PCI,improve the serum levels of IGF-Ⅰ,TGF-β1 and reduce the serum MMP-9 level,shrink the carotid plaque area and reduce the risk of adverse cardiovascular events.