阿托伐他汀和瑞舒伐他汀对高海拔地区PCI患者炎症因子和血管内皮功能的影响

发布时间：2018-07-18 21:51

【摘要】：【目的】对比分析阿托伐他汀和瑞舒伐他汀药物对高海拔地区经皮冠状动脉介入治疗(PCI)术后患者炎症因子和血管内皮功能的影响及其作用强度。【对象与方法】选自青海大学附属医院心内科2015年4月—2016年4月冠心病且行PCI术病人64例为研究对象。在给予相同基础药物治疗前提下,随机化分组分为阿托伐他汀组32例和瑞舒伐他汀组32例。观察过程中所有病人无药物漏服现象发生,期间停用所有对血脂代谢有影响的药物,所有患者均进行健康宣教和饮食习惯的干预。分别监测两组病人PCI前、PCI后3月、PCI后6月时间点总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、超敏C反应蛋白(Hs-CRP)、同型半胱氨酸(Hcy)、颈动脉内膜中层厚度(IMT)、肱动脉血流介导舒张功能(FMD)的变化。【结果】两组病人在PCI前性别比、年龄、体重指数、吸烟率、主要合并代谢性疾病等一般资料对比,无统计学差异(P0.05)。两组病人行组间比较,在PCI术前TC、TG、HDL、LDL、Hs-CRP、Hcy、IMT、FMD等指标对比,无统计学差异(P0.05)。在PCI术后3月时间点TC、TG、HDL、LDL、Hs-CRP、Hcy、IMT、FMD等指标对比,有统计学差异(P0.05)。在PCI术后6月时间点TC、TG、HDL、LDL、Hs-CRP、Hcy、IMT、FMD等指标对比,有统计学差异(P0.05)。行组内比较,阿托伐他汀组TC、TG、HDL、LDL、Hs-CRP、Hcy、IMT、FMD等指标在PCI术前、PCI后3月、PCI后6月不同时间点比较,监测指标较前逐步改善,有统计学差异(P0.05)。瑞舒伐他汀组TC、TG、HDL、LDL、Hs-CRP、Hcy、IMT、FMD等指标在PCI术前、PCI后3月、PCI后6月不同时间点比较,监测指标较前逐步改善,有统计学差异(P0.05)。【结论】阿托伐他汀和瑞舒伐他汀药物不仅对高海拔地区PCI术后患者血脂有积极调节作用,而且还能抑制机体炎症反应和改善血管内皮功能。瑞舒伐他汀较阿托伐他汀治疗高海拔地区PCI术患者效果更显著。
[Abstract]:[objective] to compare the effects of Atto vastatin and resuvastatin on inflammatory factors and vascular endothelial function in patients after percutaneous coronary intervention (PCI) at high altitude. [participants and methods] From April 2015 to April 2016, 64 patients with coronary heart disease underwent PCI from the Department of Cardiology, affiliated Hospital of Qinghai University. Under the same basic drug therapy, randomized group was divided into Atto vastatin group (n = 32) and rosuvastatin group (n = 32). During the course of observation, no drug leakage occurred in all patients, during which all drugs which had an effect on blood lipid metabolism were stopped, and all patients were given health education and diet habits intervention. Total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), hypersensitive C-reactive protein (Hs-CRP), homocysteine (Hcy) and carotid intima-media thickness (IMT) were measured at 6 months after PCI. Changes of brachial artery flow mediated diastolic function (FMD). Age, body mass index, smoking rate, major metabolic diseases and other general data, there was no statistical difference (P0.05). There was no statistical difference between the two groups before PCI (P0.05). At 3 months after PCI, there was a significant difference in TCU TGV HDLT, LDLT, Hs-CRP, HcyT, IMTMD and FMD (P0.05). At 6 months after PCI, there was a statistical difference between TCU TGV and HDLL, Hs-CRP, HcyT, IMTMD and FMD (P0.05). Intra-group comparison, the monitoring indexes of Atto vastatin group were gradually improved at different time points (P0.05). The indexes such as TCU TGG, HDL, Hs-CRP, HcyT IMT FMD and so on were compared at different time points after PCI 3 months after PCI and 6 months after PCI before PCI, and the monitoring indexes were improved gradually compared with those before PCI. There was significant difference (P0.05). [conclusion] Atto vastatin and rosuvastatin not only have a positive effect on blood lipids, but also inhibit inflammation and improve vascular endothelial function. Resuvastatin was more effective than Atto in the treatment of high altitude patients.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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