不同剂量他汀对急性心肌梗死的疗效及血hsCRP、IL-6的影响

Clinical effects of different doses of statins on hsCRP,IL-6 and effectiveness of patients with acute myocardial infarction

目的:探讨不同剂量的他汀治疗急性心肌梗死(AMI)患者的疗效,并分析对血清炎症因子超敏C-反应蛋白(hs CRP)、白介素-6(IL-6)水平的影响。方法:90例AMI患者均于发作后12 h内入院并行经皮冠状动脉介入术(PCI)治疗,随机分为2组,低剂量组45例,口服瑞舒伐他汀10 mg,高剂量组45例,口服瑞舒伐他汀20 mg,每晚1次。入院时、治疗后4周分别检测心功能指标,比较2组患者的临床疗效,比较2组患者入院后、治疗后4周血清hs CRP、IL-6水平,比较2组患者PCI术后1个月内心血管不良事件(MACE)发生情况。结果:治疗后4周,高剂量组B型利钠肽(BNP)、总胆固醇(TC)、低密度脂密白C(LDL-C)、左室舒张末期内径(LVEDD)、左室收舒末期内径(LVESD)均显著低于低剂量组,左室射血分数(LVEF)显著高于低剂量组(均P<0.05);高剂量组hs CRP、IL-6均显著低于低剂量组(P<0.05);PCI术后1个月,2组患者发生心源性死亡、再发心肌梗死、再发血运重建例数均无统计学差异(P>0.05)。结论:采用大剂量瑞舒伐他汀治疗AMI能显著改善患者心功能,降低血清hs CRP、IL-6水平,减轻炎症反应。

Objective：To discuss the clinical effects of different doses of statins on serum levels of hsCRP, IL-6 and effectiveness of patients with acute myocardial infarction （AMI）.Method：Ninety patients, which were all treated with percutaneous coronary intervention （PCI） within 12h after AMI, were divided into two groups according to the dosage of rosuvastatin：the low dose rosuvastatin group （n=45） with oral administration of 10mg rosuvastatin;the high dose group （n=45） with oral administration of 20mg rosuvastatin.The heart function indexes and hsCRP and IL-6 levels in the two groups before and 4 weeks after treatment were detected and compared.The major adverse cardiovascular events between two groups within one month after PCI were compared also.Result：Four weeks after treatment, the levels of BNP, TC, LDL-C, LVEDD and LVESD were significantly lower, and LVEF level was remarkably higher in high dose rosuvastatin group than those in low dose rosuvastatin group （P〈0.05 for all）.The levels of hsCRP and IL-6 in high dose group were markedly lower than those in low dose group （both P〈0.05）.One month after PCI, the incidence of cardiac death, recurrent myocardial infarction and revascularization in two groups showed no statistically significant difference （P〉0.05）.Conclusion：High dose rosuvastatin can evidently improve heart function of AMI, decrease the serum levels of hsCRP and IL-6, and reduce inflammatory reaction.