瑞舒伐他汀动员内皮祖细胞对心肌梗死患者心室重构的影响

Influence of endothelial progenitor cells mobilized by rosuvastatin on ventricular remodeling in patients with myocardial infarction

目的:观察心肌梗死(MI)患者使用瑞舒伐他汀后对内皮祖细胞(EPCs)的动员作用,以及其对心室重构的影响。方法:选择2017年1月至2018年1月于我科接受PCI治疗的MI患者128例。患者被随机均分为常规治疗组和瑞舒伐他汀组(在常规治疗组基础上加用瑞舒伐他汀),两组均连续治疗28d。测量比较两组治疗前、28d后的外周血EPCs比例,治疗前、结束6个月后LVEF、左室收缩末期内径(LVESd)、左室舒张末期内径(LVEDd)以及不良反应率。结果:与治疗前比较,治疗28d后瑞舒伐他汀组外周血EPCs比例[(0.64±0.15)%比(1.08±0.23)%]显著升高, P =0.001;且显著高于常规治疗组[(1.08±0.23)%比(0.58±0.12)%], P =0.001。与治疗前比较,两组治疗结束6个月后LVEF均显著升高,LVESd和LVEDd均显著降低, P 均=0.001;与常规治疗组比较,瑞舒伐他汀组LVEF[(52.24±7.18)%比(58.36±8.62)%]升高更显著,LVESd[(33.46±5.04)mm比(30.26±4.15) mm]和LVEDd[(56.17±8.24)mm比(51.38±7.62)mm]降低更显著, P 均=0.001。两组不良反应发生率无显著差异, P =0.752。结论:瑞舒伐他汀可以增加心肌梗死患者内皮祖细胞动员,抑制心室重构,显著改善心功能,使用安全,值得推广。

Objective: To observe influence of endothelial progenitor cells (EPCs) mobilized by rosuvastatin on ventricular remodeling in patients with myocardial infarction(MI). Methods: A total of 128 MI patients received PCI treated in our department from Jan 2017 to Jan 2018 were selected,randomly and equally divided into routine treatment group and rosuvastatin group (received rosuvastatin based on routine treatment group),both groups were continuously treated for 28d. Peripheral blood percentage of EPCs before and 28d after treatment,LVEF,LVESd and LVEDd before and six months after treatment,and incidence rate of adverse reactions were measured and compared between two groups. Results: Compared with before treatment,there was significant rise in peripheral blood percentage of EPCs [(0.64±0.15)% vs.(1.08±0.23)%] in only rosuvastatin group on 28d after treatment, P =0.001;and was significantly higher than that of routine treatment group [(1.08±0.23)% vs.(0.58±0.12)%], P =0.001. Compared with before treatment,there was significant rise in LVEF,and significant reductions in LVEDd and LVESd in two groups on six months after treatment, P =0.001 all;compared with routine treatment group,there was significant rise in LVEF[(52.24±7.18)% vs.(58.36±8.62)%],and significant reductions in LVESd[(33.46±5.04)mm vs.(30.26±4.15) mm] and LVEDd [(56.17± 8.24) mm vs.(51.38±7.62)mm] in rosuvastatin group, P =0.001 all. There was no significant difference in incidence rate of adverse reactions between two groups, P =0.752. Conclusion: Rosuvastatin can mobilize EPCs to inhibit ventricular remodeling,significantly improve cardiac function with good safety in patients with myocardial infarction,which is worth extending.