阿托伐他汀钙对急性心肌梗死患者免疫炎性反应及心室功能的影响

Effects of atorvastatin calcium on immune inflammatory response and ventricular function in patients with acute myocardial infarction

目的探讨阿托伐他汀对急性心肌梗死患者免疫炎性反应及心室功能的影响。方法选择2014年5月至2017年4月本院收治的急性心肌梗死患者196例,随机分为观察组和对照组,每组98例。对照组给予常规治疗,观察组联合应用阿托伐他汀口服治疗。治疗3个月后,比较两组的炎性因子及免疫功能指标、心室功能、心血管不良事件发生率等。结果治疗3个月后,观察组超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、降钙素原(procalcitonin,PCT)、CD8+T淋巴细胞比例均明显低于对照组,CD4+T淋巴细胞比例、CD4+/CD8+比值明显高于对照组(P<0.05);左心室舒张末内径(left ventricular end-diastolic diameter,LVEDd)明显低于对照组,左心室短轴缩短率(left ventricular fractional shortening,LVFS)、左心室射血分数(left ventricular ejection fraction,LVEF)明显高于对照组(P<0.05,P<0.01);心血管事件不良发生率(4.08%)明显低于对照组(17.35%),差异有显著性(χ2=9.013,P<0.01)。结论阿托伐他汀可改善急性心肌梗死患者的心室功能,预防心血管不良事件的发生,其机制可能与抑制炎症反应、调节免疫功能等有关。

Objective To investigate the effects of atorvastatin on the inflammatory response and ventricular function in patients with acute myocardial infarction. Method 196 patients with acute myocardial infarction admitted to our hospital from May 2014 to April 2017 were selected and randomly divided into the observation group and the control group, 98 cases in each group. The control group was treated with conventional western medicine, and the observation group was combined oral administration of atorvastatin. After three months of treatment, the inflammatory factors, immune function, ventricular function and adverse cardiovascular events of the two groups were compared. Result The levels of high sensitive C reactive protein（hs-CRP） and procalcitonin（PCT） and CD8＋ of the observation group were significantly lower than the control group, the levels of CD4＋ and CD4＋/CD8＋ were significantly higher than control group（t=6.096, 5.906, 3.319, 5.862, 5.577, P〈0.05）; left ventricular end diastolic diameter（LVEDd） was significantly lower than the control group, the levels of left ventricular shortening（LVFS） and left ventricular ejection fraction（LVEF） were significantly higher than the control group（t=7.589, 8.405, 7.747, P0.05, P〈0.01）; 4.08% adverse cardiovascular events was significantly lower than the control group 17.35%（χ2=9.013, P〈0.01）. Conclusion Atorvastatin can improve ventricular function and prevent adverse cardiovascular events in patients with acute myocardial infarction, which may be related to inhibiting inflammatory response and regulating immune function.