瑞舒伐他汀对冠心病患者经皮冠状动脉介入治疗术后血管内皮功能及预后的影响

Effect of atorvastatin on vascular endothelial function and prognosis of patients with coronary heart disease after percutaneous coronary intervention

目的：观察瑞舒伐他汀对冠心病患者经皮冠状动脉介入治疗（PCI）术后血管内皮功能及预后的影响。方法选取2013年1月至2015年1月行 PCI 术治疗的冠心病患者92例，通过随机数字表法将患者分为对照组（n ＝46）和观察组（n ＝46）。对照组给予口服辛伐他汀，观察组给予口服瑞舒伐他汀。测定全部患者术前、术后1 d 及术后30 d 的内皮素（ET-1）、血管性假血友病因子（VWF）、一氧化氮（NO）和 C-反应蛋白（CRP）水平，随访时间1年以上，记录 PCI 术后患者心血管事件和冠脉再狭窄发生率。结果观察组、对照组术前和术后30 d 的 VWF、ET-1水平低于术后1 d（t ＝57．797、53．747，均 P ＜0．001；t ＝4．248、24．541，均 P ＜0．001）；观察组、对照组术后30 d 的 NO 水平高于术后1 d（t ＝15．407、2．333，均 P ＜0．05）；观察组术后30 d的 VWF、ET-1水平低于对照组，NO 水平高于对照组（t ＝4．884、8．568、6．076，均 P ＜0．001）；观察组术前、术后1 d 的 CRP 水平与对照组相近（t ＝0．226，P ＝0．821）；观察组术后30 d 的 CRP 水平为（5．4±2．3）mg／L，显著低于对照组的（10．6±4．2）mg／L（t ＝7．365，P ＜0．001）。观察组的心血管事件总发生率为4．35％，显著低于对照组的32．61％（χ2＝26．558，P ＜0．001）；观察组的冠脉再狭窄率为2．17％，低于对照组的10．87％（χ2＝6．663，P ＝0．010）。结论瑞舒伐他汀能有效改善冠心病患者 PCI 术后血管内皮功能，降低心血管事件和冠脉再狭窄发生率，值得在临床中推广。

Objective To study the effect of atorvastatin on vascular endothelial function and prognosis in patients with coronary heart disease after percutaneous coronary intervention （PCI）.Methods 92 cases with coro-nary heart disease treated by PCI in our hospital from January 2013 to January 2015 were selected.They were divided into the control group（n =46）and the observation group （n =46）by random number table method.The control group was orally given simvastatin,and the observation group was orally given atorvastatin.The levels of ET -1,VWF,NO and CRP were measured in preoperation,postoperative 1 day and postoperative 30 days.Over 1 year follow -up and the incidence of cardiovascular events and restenosis after PCI were recorded.Results In the experimental group and the control group,the VWF,ET -1 levels before operation and 30 days after operation were lower than postoperative 1 day（t =57.797,53.747,all P 〈0.001;t =4.248,24.541,all P 〈0.001）.30 days after the operation,the levels of NO in the observation group and the control group were higher than 1 day after the operation（t =15.407,2.333,all P 〈0.05）.The VWF,ET -1 levels of the observation group 30 days after the operation were lower than the control group,the level of NO was higher than the control group（t =4.884,8.568,6.076,all P 〈0.001）.The CRP level of the observation group was similar to that of the control group at 1 day after operation,there was no significant differ-ence between the two groups （t =0.226,P =0.821 ）.The CRP level of 30 days after operation in the observation group was （5.4 ±2.3）mg/L,which was lower than （10.6 ±4.2）mg/L of the control group （t =7.365,P 〈0.001）. The total incidence rate of CVE in the observation group was 4.35%,which was significantly lower than 32.61% of the control group（χ2 =26.558,P 〈0.001）.The restenosis rate of the observation group was 2.17%,which was lower＆amp;nbsp;than 10.87% of the control group（χ2 =6.663,P =0.010）.Conclusion Atorvastatin can effectively improve the en-dothelial function of patients with coronary heart disease after PCI,reduce the incidence of cardiovascular events and restenosis,it is worthy of promoting in clinical.