不同剂量瑞舒伐他汀对ACS病人PCI术后血脂、肝肾功能及炎症水平的影响

Effect of Different Doses of Rosuvastatin on Blood Lipids,Liver,and Kidney Function,and Inflammation in Patients with ACS after PCI

目的探讨不同剂量瑞舒伐他汀对急性冠脉综合征(ACS)病人经皮冠状动脉介入治疗(PCI)术后血脂、肝肾功能及炎症水平的影响。方法选取2014年1月—2016年1月于我院行PCI术的ACS病人82例,随机分为观察组和对照组,各41例。对照组给予瑞舒伐他汀10mg,口服,每日1次。观察组给予瑞舒伐他汀20mg,口服,每日1次。连续服用6个月。比较两组术前1d、术后1个月、3个月、6个月血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、血尿素氮(BUN)、血清肌酐(Cr)、超敏C反应蛋白(hs-CRP)、血栓素B2(TXB2)、同型半胱氨酸(Hcy)水平。结果两组术后1个月、3个月、6个月TC、TG、LDL-C水平显著下降,与术前1d比较差异有统计学意义(P <0.05),术后组间同期比较差异均有统计学意义(P <0.05)。术后1个月、3个月、6个月HDL-C水平较术前1d呈升高趋势,术后组间同期比较差异有统计学意义(P <0.05)。两组手术前后AST、ALT、BUN、Cr水平组内以及组间同期比较差异均无统计学意义(P>0.05);术后两组术后hs-CRP、TXB2、Hcy水平较术前显著降低,差异均有统计学意义(P <0.05);术后组间同期比较差异均有统计学意义(P <0.05)。两组心血管不良事件发生率比较差异均有统计学意义(P <0.05)。结论 ACS病人PCI术后经瑞舒伐他汀强化治疗能够有效降低炎性反应,改善血脂水平,且不影响肝肾功能。

Objective To investigate the effects of rosuvastatin on the levels of blood lipid,liver and kidney function and inflammation in patients with acute coronary syndrome(ACS)after percutaneous coronary interventions(PCI).Methods Eighty two patients with ACS who underwent PCI in our hospital from January2014to January2016were randomly divided into two groups:control group(n=41)treated with orally rosuvastatin10mg,once a day,and treatment group(n=41)treated with orally rosuvastatin20mg,once a day for6months continuously.The levels of serum total cholesterol(TC),triglyceride(TG),low density lipoprotein Cholesterol(LDL C),high density lipoprotein cholesterol(HDL C),aspartate aminotransferase(AST),alanine aminotransferase(ALT),blood urea nitrogen(BUN),serum creatinine(Cr),high sensitivity C reactive protein(hs CRP),thromboxane(TXB2),and homocysteine(Hcy)were observed before surgery,1day,1month,3months,and6months after surgery.Results The TC,TG and LDL C levels of the two groups underwent surgery1month,3months and6months were significantly decreased compared with the preoperative1day values(P<0.05),and the TC,TG and LDL C levels between the two groups were statistically different at the same period(P<0.05).The postoperative HDL C level of the two groups underwent surgery1month,3months and6months was significantly increased compared with the preoperative1day values(P<0.05),and the HDL C level between the two groups were statistically different at the same period(P<0.05).AST,ALT,BUN and Cr levels were no statistically different compared with the preoperative values(P>0.05),and no statistically different between the two groups(P>0.05);The postoperative hs CRP,TXB2,Hcy inflammation indexes were significantly decreased compared with the preoperative values(P<0.05)and the indexes were statistically significant different between the two groups(P<0.05).The two groups of adverse cardiac events had significant difference(P<0.05).Conclusion The rosuvastatin treatment can effectively reduce the inflammatory response,and improve the level of blood lipids without affecting liver and kidney function.