瑞舒伐他汀对老年冠心病合并高脂血症患者心功能及血清炎症指标的影响

Effects of Rosuvastatin on Cardiac Function and Serum Inflammatory Indexes in Elderly Patients with Coronary Heart Disease Complicated with Hyperlipidemia

目的分析瑞舒伐他汀对老年冠心病合并高脂血症患者心功能、血清炎症指标的影响。方法选取2020年2月至2021年4月张家口市第一医院收治的94例冠心病合并高脂血症患者作为研究对象,按照治疗方法不同分为对照组和研究组,每组47例。其中,对照组在常规抗心血管药物治疗的基础上给予辛伐他汀,每次20 mg,每日1次;研究组在常规抗心血管药物治疗的基础上给予瑞舒伐他汀,每次10 mg,每日1次,均治疗4周。比较两组治疗前后心功能指标(左心室舒张末期内径、射血分数、心排血量)、血清炎症指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)]、血脂指标[低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)]变化,以及临床疗效和并发症发生情况。结果不同时点间、组间左心室舒张末期内径、射血分数、心排血量的主效应差异有统计学意义(P<0.05或P<0.01),时点间与组间存在交互作用(P<0.01)。治疗后,两组左心室舒张末期内径均小于治疗前,且研究组小于对照组(P<0.05);射血分数、心排血量高于治疗前,且研究组高于对照组(P<0.05)。不同时点间、组间IL-6、TNF-α、hs-CRP水平的主效应差异有统计学意义(P<0.05或P<0.01);IL-6、hs-CRP水平时点间与组间存在交互作用(P<0.05),TNF-α水平时点间与组间不存在交互作用(P>0.05)。治疗后,两组的血清IL-6、TNF-α、hs-CRP水平均低于治疗前,且研究组低于对照组(P<0.05)。不同时点间LDL-C、TC、TG水平的主效应差异有统计学意义(P<0.01);两组间LDL-C、TC水平的主效应差异有统计学意义(P<0.05),TG水平的主效应差异无统计学意义(P>0.05);LDL-C、TC水平时点间与组间存在交互作用(P<0.01),TG水平时点间与组间不存在交互作用(P>0.05)。治疗后,两组LDL-C、TC、TG水平均低于治疗前,且研究组LDL-C、TC水平低于对照组(P<0.05)。研究组的总有效率高于对照组[95.74%(45/47)比82.98%(39/47)](P<0.05)。治疗期间,两组的总并发症发生率比较差异无统计学意义(P>0.05)。结论临床应用瑞舒伐他汀治疗老年冠心病合并高脂血症的效果优于辛伐他汀,可有效促进患者心功能恢复,改善血清炎症因子、血脂水平。

Objective To analyze the effect of rosuvastatin on cardiac function and serum inflammatory indexes in elderly patients with coronary heart disease complicated with hyperlipidemia.Methods A total of 94 patients with coronary heart disease complicated with hyperlipidemia admitted to Zhangjiakou First Hospital from Feb.2020 to Apr.2021 were included,and divided into a control group and a research group according to different treatment methods,with 47 cases in each group.The control group was given simvastatin on the basis of conventional anti-cardiovascular drug treatment,20 mg each time,once a day.The research group was given rosuvastatin on the basis of conventional anti-cardiovascular drug treatment,10 mg each time,once a day.Both groups were treated for 4 weeks.The changes of cardiac function indexes[left ventricular end-diastolic diameter,ejection fraction,cardiac output],serum inflammatory indexes[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)]and blood lipid indexes[low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG)]before and after treatment,as well as the clinical efficacy and the occurrence of complications of the two groups were compared.Results There were significant differences in the main effects of left ventricular end-diastolic diameter,ejection fraction,and cardiac output between different time points and groups(P<0.05 or P<0.01),and there were interactions between time points and groups(P<0.01).After treatment,the left ventricular end-diastolic diameter of the two groups were lower than those before treatment,and the research group was smaller than the control group(P<0.05);the ejection fraction and cardiac output were higher than those before treatment,and the research group was higher than the control group(P<0.05).The main effect difference of IL-6,TNF-α,hs-CRP levels between different time points and groups was statistically significant(P<0.05 or P<0.01);there were interactions in IL-6,hs-CRP levels between time points and groups(P<0.05),there was no interaction in TNF-αlevels between time points and groups(P>0.05).After treatment,the serum levels of IL-6,TNF-αand hs-CRP in the two groups were lower than those before treatment,and the research group was lower than the control group(P<0.05).The main effect differences of LDL-C,TC,TG levels between different time points were statistically significant(P<0.01);the main effect differences of LDL-C and TC levels between the two groups was statistically significant(P<0.05),but the main effect difference of TG level was not statistically significant(P>0.05);there were interactions in LDL-C and TC levels between time points and groups(P<0.01),but there was no interaction in TG level between time points and groups(P>0.05).After treatment,the levels of LDL-C,TC and TG in the two groups were lower than those before treatment,and the levels of LDL-C and TC in the research group were lower than those in the control group(P<0.05).The total effective rate of the research group was higher than that of the control group[95.74%(45/47)vs 82.98%(39/47)](P<0.05).During the treatment period,there was no significant difference in the incidence of total complications between the two groups(P>0.05).Conclusion The clinical application of rosuvastatin in the treatment of elderly patients with coronary heart disease complicated with hyperlipidemia is better than that of simvastatin,which can effectively promote the recovery of the cardiac function and improve the levels of serum inflammatory factors and blood lipids in the patients.