瑞舒伐他汀对不稳定型心绞痛患者经皮冠状动脉介入治疗后心肌损伤标志物、炎性因子及可溶性P选择素的影响研究

摘要

目的 探究瑞舒伐他汀对不稳定型心绞痛(UAP)患者经皮冠状动脉介入治疗(PCI)后心肌损伤标志物、炎性因子及可溶性P选择素(sP-selectin)的影响.方法 选取潍坊市寒亭区人民医院2012年1月—2014年1月收治的行PCI的UAP患者162例,按照随机数字表法分为观察组和对照组,每组81例.对照组患者在常规药物治疗基础上给予阿托伐他汀钙片治疗,观察组患者在常规药物治疗基础上给予瑞舒伐他汀钙片治疗.比较两组患者术前及术后12 h、24 h心肌损伤标志物〔 肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白(cTnI)、人心型脂肪酸结合蛋白(h-FABP)〕、炎性因子〔 超敏C反应蛋白(hs-CRP)、肿瘤坏死因子 α(TNF-α)、干扰素 γ(IFN-γ)、白介素10(IL-10)〕及术前和术后12 h血清sP-selectin水平.结果 术前及术后12 h、24 h两组患者血清CK-MB、cTnI、h-FABP水平比较,差异有统计学意义(P<0.05);且术后24 h观察组患者血清CK-MB、cTnI、h-FABP水平低于对照组(P<0.05).手术前后血清CK-MB、cTnI、h-FABP水平比较,差异有统计学意义(P<0.05);两组患者血清CK-MB、cTnI、h-FABP水平时间与组间均存在交互作用(P<0.05).术前及术后12 h、24 h两组患者血清hs-CRP、TNF-α、IFN-γ及IL-10水平比较,差异有统计学意义(P<0.05);且术后24 h观察组患者血清hs-CRP、TNF-α、IFN-γ 及IL-10水平低于对照组(P<0.05).手术前后血清hs-CRP、TNF-α、IFN-γ及IL-10水平比较,差异有统计学意义(P<0.05);两组患者血清hs-CRP、TNF-α、IFN-γ及IL-10水平时间与组间均存在交互作用(P<0.05).两组患者术前血清sP-selectin水平比较,差异无统计学意义(P>0.05);观察组患者术后24 h血清sP-selectin水平低于对照组(P<0.05).观察组患者手术前后血清sP-selectin水平比较,差异无统计学意义(P>0.05).结论 瑞舒伐他汀能有效减轻UAP患者PCI后心肌损伤,降低炎性因子及sP-selectin水平,具有心肌保护作用.%Objective To investigate the impact of rosuvastatin on myocardial injury markers,inflammatory cytokines and soluble P - selectin of unstable angina pectoris patients undergoing PCI. Methods From January 2012 to January 2014,a total of 162 patients with unstable angina pectoris were selected in the People's Hospital of Hanting District,Weifang,and they were divided into control group and observation group according to random number table,each of 81 cases. Based on conventional medical treatment,patients of control group were given extra atorvastatin calcium tablets,while patients of observation group were given rosuvastatin calcium tablets. CK-MB,cTnI,h-FABP,hs-CRP,TNF-α,IFN-γ,IL-10 were compared between the two groups before PCI,after 12 hours and 24 hours of PCI. Seurm soluble P - selectin was compared between the two groups before and after 24 hours of PCI. Results There were statistically significant differences of serum levels of CK-MB,cTnI and h-FABP between the two groups before PCI,after 12 hours and 24 hours of PCI,and serum levels of CK-MB,cTnI and h-FABP of observation group were statistically significantly lower than those of control group after 24 hours of PCI. There were statistically significant differences of serum levels of CK-MB,cTnI and h-FABP before PCI and after PCI( P < 0. 05),and interaction existed between time and interblock(P < 0. 05). There were statistically significant differences of serum levels of hs-CRP,TNF-α,IFN-γ and IL-10 between the two groups before PCI,after 12 hours and 24 hours of PCI,and serum levels of hs-CRP,TNF-α,IFN-γ and IL-10 of observation group were statistically significantly lower than those of control group after 24 hours of PCI. There were statistically significant differences of serum levels of hs-CRP,TNF-α,IFN-γ and IL-10 before PCI and after PCI(P< 0. 05),and interaction existed between time and interblock( P < 0. 05). No statistically significant differences of serum soluble P - selectin level was found between the two groups before PCI(P > 0. 05);while serum soluble P - selectin level of observation group was statistically significantly lower than that of control group after 24 hours of PCI(P < 0. 05). No statistically significant differences of serum soluble P - selectin level of observation group was found before or after PCI( P > 0. 05). Conclusion Rosuvastatin can effective relieve the myocardial injury of unstable angina pectoris patients treated by PCI,reduce the inflammatory cytokines levels and soluble P - selectin level,has certain cardioprotective effect.