普罗布考联合瑞舒伐他汀对冠心病PCI术后病人肾功能及MCP-1、sICAM-1、sVCAM水平的影响

Influences of Probucol Combined with Rosuvastatin on the Renal Function and the Levels of MCP-1,sICAM-1,sVCAM in Patients with Coronary Heart Disease after PCI

目的探讨普罗布考联合瑞舒伐他汀对冠心病经皮冠状动脉介入术(PCI)后肾功能及单核细胞趋化蛋白-1(MCP-1)、可溶性细胞间黏附分子1(sICAM-1)、可溶性血管细胞黏附分子(sVCAM)水平的影响。方法选取114例择期行PCI术的冠心病病人作为研究对象,采用随机数字表法分为对照组与观察组,每组57例。对照组给予瑞舒伐他汀治疗,观察组给予普罗布考联合瑞舒伐他汀治疗。比较两组治疗前及术后3 d血肌酐(Scr)、尿酸(UA)、尿素氮(BUN)水平,并计算肾小球滤过率(eGFR),统计两组对比剂肾病(CIN)发生率;并比较血清MCP-1、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、髓过氧化物酶(MPO)、sICAM-1、sVCAM、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)水平。观察两组主要不良心血管事件(MACE)发生情况。结果术后3 d,两组UA水平均较术前明显降低(P<0.05);观察组Scr、BUN水平无明显变化(P>0.05),对照组Scr、BUN水平明显升高(P<0.05);观察组Scr、UA、BUN水平均明显低于对照组(P<0.05);两组eGFR组内及组间比较差异无统计学意义(P>0.05);两组CIN发生率比较,差异无统计学意义(P>0.05);术后3 d,两组血清MCP-1、IL-6、IL-10及MPO水平均明显降低(P<0.05),且观察组明显低于对照组(P<0.05);术后3 d观察组sICAM-1、sVCAM水平均明显降低(P<0.05),对照组无明显变化(P>0.05);术后3 d,观察组MMP-2、MMP-9、sICAM-1、sVCAM水平低于对照组,差异有统计学意义(P<0.05);观察组MACE发生率明显低于对照组(P<0.05)。结论普罗布考联合瑞舒伐他汀能够有效保护PCI术后冠心病病人肾功能,降低血清MCP-1、sICAM-1、sVCAM水平,且CIN与MACE发生率低。

Objective To investigate the effect of Probucol combined with Rosuvastatin on the renal function and the levels of monocyte chemoattractant protein-1(MCP-1),soluble intercellular adhesion molecule 1(sICAM-1),and soluble vascular cell adhesion molecule(sVCAM) in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods One hundred and fourteen patients with coronary heart disease scheduled for PCI were selected,and were randomly divided into the control group and the observation group by random number table,with 57 cases in each group.The patients in control group were treated with Rosuvastatin,and the patients in observation group were treated with Probucol combined with Rosuvastatin.The serum creatinine(Scr),uric acid(UA),urea nitrogen(BUN) levels,glomerular filtration rate(eGFR),the incidence rate of contrast induced nephropathy(CIN),and the levels of serum MCP-1,interleukin-6(IL-6),interleukin-10(IL-10),myeloperoxidase(MPO),sICAM-1,sVCAM,matrix metalloproteinase-2(MMP-2),and matrix metalloproteinase(MMP-9) were compared.The incidences of major adverse cardiovascular events(MACE) in two groups were observed.Results On the 3 rd days after operation,compared with data before operation,the level of UA in two groups decreased significantly(P<0.05).There was no significant difference in the level of Scr and BUN in observation group(P>0.05),the level of Scr and BUN in the control group was significantly increased(P<0.05);the levels of Scr,UA,and BUN in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the eGFR between two groups(P>0.05).There was no significant difference in the incidence rate of CIN between two groups(P>0.05).On the 3 rd days after operation,the levels of serum MCP-1,IL-6,IL-10,and MPO in two groups were significantly decreased(P<0.05),and that in observation group was significantly lower than thiose in the control group(P<0.05);the levels of sICAM-1 and sVCAM in the observation group were decreased significantly(P<0.05),there was no significant difference in the control group(P>0.05);There was no significant difference in the levels of MMP-2 and MMP-9 between two groups(P>0.05),and that in observation group were significantly lower than those in the control group(P<0.05).The incidence rate of MACE in the observation group was significantly lower than that in the control group(P< 0.05).Conclusion Probucol combined with Rosuvastatin could effectively protect the renal function of patients with coronary heart disease after PCI,reduce the levels of serum MCP-1,sICAM-1,and sVCAM,lower the incidence rates of CIN and MACE.