不同剂量瑞舒伐他汀对冠心病介入术后患者心肌指标、血脂水平及心血管不良事件的影响

Effects of rosuvastatin in different doses on myocardial indexes,serum lipid level and adverse cardiovascular events in patients with coronary heart disease after percutaneous coronary intervention

目的观察不同剂量瑞舒伐他汀对冠心病经皮冠状动脉介入术(PCI)后患者心肌指标、血脂水平及心血管不良事件的影响。方法选取2018年3月至2019年3月南阳市第一人民医院收治的86例冠心病PCI术后患者,采用随机数字表法分为对照组和观察组,每组43例。对照组给予5 mg/次、1次/d的瑞舒伐他汀钙治疗,观察组给予10 mg/次、1次/d的瑞舒伐他汀钙治疗。比较两组血脂水平[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)]、炎性因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)]、心肌指标[肌钙蛋白-I(cTn-I)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)]、心血管不良事件发生率和药物不良反应发生率。结果治疗后,两组TC、TG、LDL-C、IL-6、CRP、cTn-I、CK、CK-MB水平较治疗前降低,且治疗后观察组TC、TG、LDLC、IL-6、CRP、cTn-I、CK、CK-MB水平低于对照组(P<0.05)。观察组心血管不良事件发生率为4.65%(2/43),低于对照组的20.93%(9/43),P<0.05;两组药物不良反应总发生率比较差异未见统计学意义(P>0.05)。结论高剂量瑞舒伐他汀治疗冠心病PCI术后患者,在调节患者血脂水平、减轻炎性反应、保护心肌细胞以及减少心血管不良事件方面的优势较低剂量瑞舒伐他汀更为明显。

Objective To observe the effects of rosuvastatin in different doses on myocardial indexes, serum lipid level and adverse cardiovascular events in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).Methods Eighty-six patients with CHD treated by PCI in Nanyang First People’s Hospital from March 2018 to March 2019 were selected. According to random number table method, they were divided into control group and observation group, with 43 cases in each group. The control group was treated with rosuvastatin calcium, 5 mg/time, 1 time/day;while the observation group was treated with rosuvastatin calcium, 10 mg/time, 1 time/day. The serum lipid levels, such as total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C), inflammatory factors, such as interleukin-6 (IL-6), C-reactive protein (CRP), myocardial indicators, such as troponin-I (cTn-I), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), incidence of adverse cardiovascular events and drug adverse reactions were compared between the two groups.Results After treatment, the levels of TC, TG, LDL-C, IL-6, CRP, cTn-I, CK and CK-MB in the two groups were lower than those before treatment, and the above indexes in the observation group were lower than those in the control group (P<0.05). The incidence of adverse cardiovascular events in the observation group was 4.65% (2/43), lower than 20.93% (9/43) in the control group (P<0.05). There was no significant difference in total incidence of drug adverse reactions between the two groups (P>0.05).ConclusionsThe advantages of high-dose rosuvastatin in treatment of CHD patients after PCI is more significant than low-dose rosuvastatin in adjusting their serum lipid level, reducing inflammatory response, protecting cardiomyocytes and reducing adverse cardiovascular events.