瑞舒伐他汀对冠状动脉粥样硬化性心脏病患者的白介素、C反应蛋白、肿瘤坏死因子等炎症因子的影响及临床意义

Effect of Rosuvastatin on Inflammatory Factors such as Interleukin,C-Reactive Protein and Tumor Necrosis Factor in Patients with Coronary Atherosclerotic Heart Disease and its Clinical Significance

目的:探讨瑞舒伐他汀对冠状动脉粥样硬化性心脏病患者的白介素(IL)、C反应蛋白(CRP)、肿瘤坏死因子(TNF)等炎症因子的影响及临床意义。方法:选取2016年4月~2019年10月本院收治的86例冠状动脉粥样硬化性心脏病患者作为研究对象。按照随机数字表法分为研究组(n=43)和对照组(n=43)。研究组给予常规治疗+瑞舒伐他汀(10 mg/次,1次/天)治疗,对照组给予常规治疗+阿托伐他汀(40 mg/次,1次/天)治疗,两组均连续治疗2个月。检测比较两组治疗前和治疗后的血脂[甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]、氨基末端脑钠肽前体(NT-proBNP)、炎症因子[CRP、白介素-6(IL-6)、白介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)]水平以及颈动脉内膜中层厚度(IMT)。分析两组患者CRP、IL-6、IL-18、TNF-α水平与血脂(TG、TC、LDL-C、HDL-C)水平、NT-proBNP水平和IMT的关系。并统计比较两组不良反应发生率。结果:两组治疗后TG、TC、LDL-C、CRP、NT-proBNP、IL-6、IL-18、TNF-α水平和IMT均低于治疗前,HDL-C水平高于治疗前(P <0.05);研究组治疗后TG、TC、LDL-C、CRP、NT-proBNP、IL-6、IL-18、TNF-α水平和IMT均低于对照组,HDL-C水平高于对照组(P <0.05);Pearson相关分析结果显示,两组患者CRP、IL-6、IL-18、TNF-α水平与TG、TC、LDL-C、NT-proBNP水平和IMT均呈正相关(P <0.05),与HDL-C水平呈负相关(P <0.05);两组不良反应发生率比较无统计学差异(P>0.05)。结论:瑞舒伐他汀可安全有效地降低冠状动脉粥样硬化性心脏病患者炎症因子水平,且其炎症因子水平与脂代谢、心功能和动脉粥样硬化均相关。

Objective:To investigate the effect of rosuvastatin on inflammatory factors such as interleukin(IL),C-reactive protein(CRP)and tumor necrosis factor(TNF)in patients with coronary atherosclerotic heart disease and its clinical significance.Methods:A total of 86 patients with coronary atherosclerotic heart disease admitted to our hospital from April 2016 to October 2019 were selected as the study subjects.Random number table method was used to divide the patients into study group(n=43)and control group(n=43).The study group was treated with conventional therapy and rosuvastatin(10 mg/time,1 time/day),while the control group with conventional therapy and atorvastatin(40 mg/time,1 time/day).Both groups were treated for 2 consecutive months.Plasma lipid[riglyceride(TG),cholesterol(TC),low-density lipoprotein(LDL-C),high-density lipoprotein(HDL-C)]levels,serum amino-terminal brain natriuretic peptide precursor(NT-proBNP)levels,inflammatory factors[CRP,interleukin-6(IL-6),interleukin-18(IL-18),tumor necrosis factor-α(TNF-α)]levels and carotid intima-media thickness(IMT)between the two groups before and after treatment were detected and compared.The relationship between plasma CRP level,serum IL-6,IL-18,TNF-αlevel with serum lipid(TG,TC,LDL-C,HDL-C)levels,serum NT-proBNP level and IMT in patients was analyzed in the two groups.The rate of adverse reactions between the two groups was compared statistically.Results:After treatment,plasma TG,TC,LDL-C,CRP,serum NT-proBNP,IL-6,IL-18,TNF-αlevel and IMT in the two groups were all lower than those of before treatment,while HDL-C level was higher than that of before treatment(P<0.05).After treatment,plasma TG,TC,LDL-C,CRP level,serum NT-proBNP,IL-6,IL-18,TNF-αlevel and IMT in the study group were all lower than those of the control group,while HDL-C level in the study group was higher than that of the control group(P<0.05).Pearson correlation analysis results showed that plasma CRP level and serum IL-6,IL-18,TNF-αlevels were positively correlated with plasma TG,TC,LDL-C level,serum NT-proBNP level and IMT in both groups(P<0.05),while negatively correlated with plasma HDL-C level(P<0.05).There was no significant difference in the rate of adverse reactions between the two groups(P>0.05).Conclusion:Rosuvastatin can safely and effectively reduce the level of inflammatory factors in patients with coronary atherosclerotic heart disease.And the levels of inflammatory factors are related to lipid metabolism,cardiac function and atherosclerosis.