瑞舒伐他汀对急性冠脉综合征患者血浆胎盘生长因子和B型钠尿肽水平及预后的影响

摘要

目的：探讨瑞舒伐他汀对急性冠脉综合征患者血浆胎盘生长因子和B型钠尿肽水平及预后的影响。方法选择2012—2013年连云港市第二人民医院收治的急性冠脉综合征患者96例，按照随机双盲原则分为观察组和对照组，各48例。两组患者均根据病情给予硝酸酯类药物、β受体阻滞剂、钙通道阻滞剂、抗血小板、抗凝、溶栓或介入治疗。在此基础上，对照组患者给予辛伐他汀治疗，观察组患者给予瑞舒伐他汀治疗。比较入院24 h、干预4周及6个月两组患者血浆胎盘生长因子及B型钠尿肽水平；比较随访期间两组患者再住院次数、总住院时间、心血管事件发生率及治疗期间药物不良反应发生情况。结果两组患者入院24 h血浆胎盘生长因子和B型钠尿肽水平比较，差异无统计学意义（P﹥0.05）；干预4周及6个月观察组患者血浆胎盘生长因子和 B 型钠尿肽水平均低于对照组（P ﹤0.05）。直线相关分析结果显示，血浆胎盘生长因子水平与血浆B型钠尿肽水平呈正相关（ r=0.56，P﹤0.05）。随访期间观察组患者再住院次数少于对照组，总住院时间短于对照组，心血管事件发生率低于对照组（ P﹤0.05）。观察组患者药物不良反应发生率为20.0％，对照组为14.3％，差异无统计学意义（P﹥0.05）。两组患者均未见肌溶解、肾衰竭、血管神经性水肿等严重药物不良反应。结论瑞舒伐他汀能有效降低ACS患者血浆胎盘生长因子和B型钠尿肽水平，改善患者预后，且未增加药物不良反应。%Objective To investigate the impact of rosuvastatin on plasma placenta growth factor and BNP levels and prognosis of patients with acute coronary syndrome. Methods A total of 96 patients with acute coronary syndrome were selected in the Second People's Hospital of Lianyungang from 2012 to 2013 , and they were divided into observation group and control group according to randomized,double-blind principle,each of 48 cases. Patients of both groups received nitrate esters,β-blockers,calcium channel blockers,antiplatelet therapy,anticoagulation therapy,thrombolysis therapy and PCI according to the illness and condition of each patient. Patients of control group received extra simvastatin,while patients of observation group received extra rosuvastatin. Plasma placenta growth factor and BNP levels were compared between the two groups within 24 hours after admission,4 weeks after treatment and 6 months after treatment;rehospitalization times,total hospital stays,incidence of cardiovascular events during fellow-up and incidence of drug adverse reactions during treatment were recorded. Results No statistically significant differences of plasma placenta growth factor or BNP level was found between the two groups within 24 hours after admission(P﹥0. 05);plasma placenta growth factor and BNP levels of observation group were lower than those of control group 4 weeks after treatment and 6 months after treatment ( P ﹤0. 05 ). Linear correlation analysis showed that, plasma placenta growth factor level was positively correlated with plasma BNP level(r=0. 56,P﹤0. 05). Rehospitalization times of observation group was less than that of control group,total hospital stays of observation group was shorter than that of control group,incidence of cardiovascular events of observation group was lower than that of control group(P﹤0. 05). The incidence of drug adverse reactions of observation group was 20. 0%,that of control group was 14. 3%,the difference was not statistically significantly different( P ﹥0. 05 ). No one of the two groups occurred myolysis, renal failure, angioneurotic edema during treatment. Conclusion Rosuvastatin can effectively reduce the plasma placenta growth factor and BNP levels of patients with acute coronary syndrome,improve the patients'prognosis,without increasing the incidence of drug adverse reactions.