不同剂量瑞舒伐他汀对急性心肌梗死患者冠脉介入术后内皮功能的影响

Influence of different doses Rosuvastatin on endothelial function in patients with acute myocardial infarction after percutaneous coronary intervention

目的观察不同剂量瑞舒伐他汀对急性心肌梗死（AMI）患者成功施行冠脉介入治疗（PCI）术后血管内皮功能的影响。方法选择2011年10月至2013年10月在本院确诊为冠心病、急性心肌梗死并成功行冠脉支架成形术的患者93例，分为A、B两组，A组48例，B组45例。两组患者均常规抗凝、抗血小板治疗，应用逆转心室重塑药物。A组在常规治疗基础上加用瑞舒伐他汀片10mg，B组患者在常规治疗基础上加用瑞舒伐他汀20mg。两组患者均于入院即刻，术后1d、30d时测定外周血一氧化氮（NO）、可溶性细胞间黏附分子-1（slCAM-1）、高敏C-反应蛋白（hs-CRP）及血脂水平。研究不同剂量瑞舒伐他汀对炎性指标、内皮功能及血脂的影响。结果AMI患者slCAM-1、NO、Hs-CRP水平均较正常值明显升高。10mg瑞舒伐他汀和20mg瑞舒伐他汀均可以显著降低患者slCAM-1、NO、hs-CRP水平（P均〈0．01），20mg瑞舒伐他汀较10mg瑞舒伐他汀降低slCAM-1、NO、hs—CRP水平更为显著（P均〈0．05）。结论瑞舒伐他汀可以降低血管炎性反应、改善血管内皮，大剂量的瑞舒伐他汀较常规剂量效应强。

Objective To observe the influence of different doses Rosuvastatin on endothelial function in patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）. Methods A total of 93 patients with AMI after PCI were enrolled, randomly and equally divided into A, B two groups： group A in 10 mg Rosuvastatin and B group of 20 mg Rosuvastatin. Two groups of patients were routine given anticoagulation, antiplatelet and reversing ventricular remodeling medications. The levels of soluble intercellular adhesion molecule-1 （slCAM-I）, nitric oxide（NO）, high-sensitivity C-reactive protein（hs-CRP） and blood lipid were analyzed after 1 day and 30 days treatment. Results The level of slCAM-1, NO, hs-CRP were significantly increased after ldays treatment in both groups. The serum level of slCAM-1, NO, hs-CRP in both groups were significantly de- creased after 30 days treatment （P〈0.01）. And this decrease was more significantly in B group compared to A group （P〈0.05）. Conclusion Rosuvastatin may reduce vascular inflammatory reaction, improve the vascular en- dothelium, and large dose of Rosuvastatin has more stronger effect than routine dose.