瑞舒伐他汀强化治疗对支架置入术后患者血管再狭窄的影响

The Influence of Rosuvastatin Intensive Therapy on the ISR of Patients with Placement of Stents in Coronary Artery

目的:探究瑞舒伐他汀强化治疗对行冠状动脉支架置入术后患者再狭窄率、血管内皮功能和血脂水平的影响。方法:选择2013年1月~2015年12月90例于我院行冠状动脉支架置入术后的患者。按照治疗方法的不同将患者随机分为观察组及对照组,每组45例。观察组患者术后给予20 mg/天瑞舒伐他汀强化治疗,对照组患者术后给予常规剂量(5~10 mg/天)瑞舒伐他汀治疗,连续服用6个月。比较两组患者治疗前后的血脂、C反应蛋白(CRP)、白介素8(IL-8)、一氧化氮合酶(e NOS)、内皮素-1(ET-1)水平及术后6个月支架内再狭窄率(ISR)。结果:治疗后,两组患者的胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)水平均较治疗前显著降低(P<0.05),且观察组患者以上指标均显著低于对照组(P<0.05);观察组患者高密度脂蛋白(HDL-C)水平较治疗前增加明显(P<0.05),而对照组该指标无明显改善(P>0.05)。治疗后,两组患者的CRP、IL-8水平均较治疗前显著降低(P<0.05),且观察组患者以上指标显著低于对照组(P<0.05);观察组患者的一氧化氮合酶(e NOS)水平较治疗前显著提高,血管内皮素-1(ET-1)水平显著降低(P<0.05),但对照组以上指标与治疗前相比无明显差异(P>0.05)。术后6个月,观察组患者支架内再狭窄率(ISR)显著低于对照组(P<0.05)。结论:瑞舒伐他汀强化治疗可通过显著改善患者血脂水平,减轻患者机体炎症状态,积极恢复内皮组织损伤,进而预防ISR的发生。

Objective：To explore the influence ofrosuvastatin intensive therapy on the ISR,vascular endothelial function and level of blood lipid of patients with placement of stents in coronary artery.Methods：90 patients with placement of stents in coronary artery treated in our hospital from January,2013 to December,2015 were randomly divided into the observation and control group with each group of 45 cases.Observation group was given rosuvastatin intensive therapy （20 mg/d）,control group received conventionaltherapy （5～10 mg/d）,the therapy last for 6 month.The blood lipid,level of IL-8,CRP,eNOS,ET-1 were compared in both groups.Results：After therapy,the level ofTC,TG,LDL-C in both groups were obviously decreased compared with that of before therapy （P〈0.05）,and that of the observation group were significantly lower than the control group （P〈0.05）;the level of HDL-C in observation group increased obviously compared with that of before therapy （P〈0.05）,and that of control group showed no significant difference （P 〉 0.05）;the level of CRP、IL-8 in both group decreased obviously （P 〈 0.05）,and those of observation group were significantly lower than control group （P〈 0.05）;in the observation group,the level of eNOSincreased and ET-1 decreased significantly compared with those of before therapy,whereas the level of eNOS,ET-1 keep unchanged in control group;after treating for 6 months,the occurrence rate ofISR in observation group was significantly lower than control group.Conclusion：Rosuvastatin intensive therapy was effective methods in preventing the occurrence of ISR by improving blood lipid,down regulating levels of IL-8 and CRP,repairing endothelial tissue damage.