瑞舒伐他汀与阿托伐他汀对不稳定性心绞痛患者PCI术后心肌损伤、炎性因子和可溶性P选择素的影响比较

Comparison of effect of Rosuvastatin and Atorvastatin on myocardial injury, inflammatory factors and soluble P selectin in patients with unstable angina pectoris after PCI

目的探讨瑞舒伐他汀与阿托伐他汀对不稳定性心绞(UAP)痛患者经皮冠状动脉介入治疗(PCI)术后心肌损伤、炎性因子和可溶性P选择素(s P-S)的影响。方法选择2015年12月~2017年10月绵阳市中心医院诊断为UAP且拟实施PCI进行治疗的住院患者100例,按照随机数字表法分为阿托伐他汀组(50例)和瑞舒伐他汀组(50例)。两组患者均在PCI手术前1周给予常规治疗。在常规治疗基础上,阿托伐他汀组每天服用20 mg阿托伐他汀钙片,瑞舒伐他汀组每天服用10 mg瑞舒伐他汀钙片,连续治疗7 d。比较两组患者的心肌损伤指标、炎性因子及s P-S水平。结果心肌损伤指标方面,术后24 h,阿托伐他汀组的心肌肌钙蛋白I、血清肌酸激酶同工酶均较用药前显著升高(P<0.05),且明显高于同一时期的瑞舒伐他汀组(P<0.05)。炎症因子方面,术后24 h,阿托伐他汀组的肿瘤坏死因子α、白介素-6和高敏C反应蛋白水平均较用药前显著升高,且明显高于同一时期的瑞舒伐他汀组(P<0.05);两组白介素-10水平比用药前显著升高,且瑞舒伐他汀组高于阿托伐他汀组(P<0.05);而s P-S水平方面,两组均显著增加,且阿托伐他汀组高于瑞舒伐他汀组(P<0.05)。结论 UAP患者实施PCI术前给予瑞舒伐他汀相较于阿托伐他汀更能显著降低炎性因子水平,改善心肌损伤。

Objective To investigate the effect of Rosuvastatin and Atorvastatin on myocardial injury,inflammatory factors and soluble P selectin(sP-S)in patients with unstable angina pectoris after PCI.Methods From December 2015 to October 2017,in Mianyang Central Hospital,100 patients with UAP undergoing PCI were selected,according to random number table method,they were divided into Atorvastatin group(50 cases)and Rosuvastatin group(50 cases).Two groups were treated with general care one week before surgery,and then,the atorvastatin group was treated with 20 mg/d Atorvastatin for 7 d,the Rosuvastatin group was treated with 10 mg/d rosuvastatin for 7 d.The indexes levels of cardiac injury,inflammatory factors and sP-S in two groups were compared.Results About indexes of cardiac injury,24 h after operation,the level of cTnI and CK-MB in Atorvastatin group were significantly higher than before medication(P<0.05),and these were significantly higher than Rosuvastatin group at the same period(P<0.05).About inflammatory factors,the level of TNF-α,IL-6 and hs-CRP in Atorvastatin group were significantly higher than before medication,and these were significantly higher than Rosuvastatin group at the same period(P<0.05);the level of IL-10 of two groups were significantly higher than before medication,and that of Rosuvastatin group was much higher than Atorvastatin group(P<0.05).The level of sP-S of the two groups was significantly increased,and that of Atorvastatin group was much higher than Rosuvastatin group(P<0.05).Conclusion Before the implementation of PCI,it can more significantly decrease the level of inflammatory factors and improve myocardial injury that UAP patients were given Rosuvastatin than Atorvastatin.