介入治疗联合降血清同型半胱氨酸治疗对冠心病患者血清微炎症介质水平的影响

Effect of Interventional Therapy Combined with Serum Homocysteine Lowering on the Serum Levels of Microinflammatory Mediators of Patients with Coronary Heart Disease

目的:探讨介入治疗联合降同型半胱氨酸治疗对冠心病患者血清微炎症介质水平的影响。方法:选择2014年1月至2017年1月我院收治的冠心病患者82例,随机分成研究组和对照组,各41例。对照组患者同时使用氯吡格雷、阿司匹林、他汀类药物和β-阻滞剂等常规用药进行治疗,研究组患者在常规治疗的基础上联合使用叶酸、B组维生素进行降同型半胱氨酸治疗。连续治疗半年后,观察和比较两组患者治疗前后的血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)、可溶性细胞间粘附因子-1(ICAM-1)、N末端脑钠肽前体水平(NTpro-BNP)和血清同型半胱氨酸(Hcy)水平的变化情况。结果:治疗前,两组患者血清Hcy、L-6、CRP、PCT、ICAM-1和NTpro-BNP水平比较差异均无统计学意义(P>0.05)。治疗后,两组患者血清Hcy、L-6、CRP、PCT、ICAM-1和NTpro-BNP水平均较治疗前显著降低,且研究组以上指标明显低于对照组(P<0.05)。结论:介入治疗联合降同型半胱氨酸治疗冠心病患者可有效其血清Hcy水平,减轻机体的炎症反应,有效发挥保护心肌功能的作用。

Objective： To investigate the effect of interventional therapy combined with serum homocysteine lowering on the serum levels of microinflammatory mediators of patients with coronary heart disease（CHD）. Methods： 80 patients with CHD who were treated in our hospital from January 2014 to January 2017 were randomly divided into the study group and the control group, with 41 cases in each group. Patients in the control group were treated with clopidogrel, Aspirin, statins and β-blockers and other conventional medication, the study group of patients in the conventional treatment based on the combination of folic acid, B group of vitamin down-type cysteine treatment. All the patients were continuously treated for six months, the serum interleukin-6（IL-6）, c-reactive protein（CRP）, calcitonin（PCT）, soluble intercellular adhesion factor 1（ICAM-1）, N terminal brain natriuretic peptide precursor levels（NTpro-BNP） and homocysteine（Hcy） levels were compared between two groups of patients before and after treatment. Results： There was no significant difference in the levels of serum Hcy, L-6, CRP, PCT, ICAM-1 and NTpro-BNP between the two groups before treatment（P〉0.05）. After treatment, the serum Hcy, L-6, CRP, PCT, ICAM-1 and NTpro-BNP levels of both groups were significantly lower than before treatment,and the above indexes were significantly lower in the study group than those in the control group（P〈0.05）. Conclusions： Interventional therapy combined with serum homocysteine lowering was effective in treating CHD patients, it reduced the inflammatory response and effectively protected the cardiac function.