阿托伐他汀联合替罗非班对冠心病PCI术后患者炎症因子及血管内皮功能的影响

Effect of atorvastatin combined with tirofiban on inflammatory factors and vascular endothelial function in patients with coronary heart disease after PCI

目的分析阿托伐他汀联合替罗非班对冠心病经皮冠状动脉介入治疗(PCI)术后患者的应用效果。方法68例接受PCI治疗的冠心病患者,以抽签法分为对照组及研究组,每组34例。对照组术后单用阿托伐他汀治疗,研究组术后在对照组的基础上加用替罗非班治疗。比较两组患者治疗前后的心功能指标[左室射血分数(LVEF)、每搏输出量(SV)]、血管内皮功能指标[一氧化氮(NO)、内皮素1(ET-1)、血管性血友病因子(vWF)]、炎性因子[超敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)、肿瘤坏死因子-α(TNF-α)]水平、生活质量评分、不良心血管事件发生率。结果治疗后,研究组患者的LVEF(57.32±5.40)%、SV(67.22±7.40)ml均高于对照组的(51.21±5.10)%、(61.40±7.55)ml,差异具有统计学意义(P<0.05)。治疗后,研究组患者的NO(83.24±2.36)μmol/L高于对照组的(73.98±3.54)μmol/L,ET-1(64.23±4.21)ng/L、vWF(103.31±6.55)%低于对照组的(80.23±4.35)ng/L、(148.84±8.29)%,差异具有统计学意义(P<0.05)。治疗后,研究组患者的hs-CRP(3.88±0.27)mg/L、CK-MB(23.29±2.99)U/L、TNF-α(3.88±0.22)ng/L均低于对照组的(5.77±0.40)mg/L、(62.21±4.54)U/L、(5.72±0.40)ng/L,差异具有统计学意义(P<0.05)。研究组患者的不良心血管事件发生率8.82%低于对照组的29.41%,差异具有统计学意义(P<0.05)。治疗后,研究组患者的生活质量评分(81.21±7.50)分高于对照组的(71.21±7.10)分,差异具有统计学意义(P<0.05)。结论冠心病PCI术后患者应用阿托伐他汀联合替罗非班治疗可显著改善心功能和血管内皮功能,降低炎性因子水平,预防各类不良心血管事件的发生,提升患者的生活质量。

Objective To analyze the application effect of atorvastatin combined with tirofiban on inflammatory factors and vascular endothelial function in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 68 patients with coronary heart disease treated by PCI were divided into control group and research group by lottery method,with 34 cases in each group.The control group was treated with atorvastatin alone,and the research group was treated with tirofiban on the basis of the control group.Both groups were compared in terms of cardiac function indexes[left ventricular ejection fraction(LVEF),stroke volume(SV)],vascular endothelial function indexes[nitric oxide(NO),endothelin-1(ET-1),von Willebrand factor(vWF)],inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB),tumor necrosis factor-α(TNF-α)]levels,quality of life score,and incidence of adverse cardiovascular events.Results After treatment,the LVEF(57.32±5.40)%and SV(67.22±7.40)ml of the research group were higher than(51.21±5.10)%and(61.40±7.55)ml of the control group,and the differences were statistically significant(P<0.05).After treatment,the NO(83.24±2.36)μmol/L in the research group was higher than(73.98±3.54)μmol/L in the control group;the ET-1(64.23±4.21)ng/L,vWF(103.31±6.55)%in the research group were lower than(80.23±4.35)ng/L,(148.84±8.29)%in the control group;the differences were all statistically significant(P<0.05).After treatment,the hs-CRP(3.88±0.27)mg/L,CK-MB(23.29±2.99)U/L and TNF-α(3.88±0.22)ng/L in the research group were lower than(5.77±0.40)mg/L,(62.21±4.54)U/L and(5.72±0.40)ng/L in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse cardiovascular events 8.82%in the research group was lower than 29.41%in the control group,and the difference was statistically significant(P<0.05).After treatment,the quality of life score of the research group(81.21±7.50)points was higher than(71.21±7.10)points of the control group,and the difference was statistically significant(P<0.05).Conclusion Atorvastatin combined with tirofiban in the treatment of patients with coronary heart disease after PCI can significantly improve their cardiac function and vascular endothelial function,reduce the level of inflammatory factors,prevent all kinds of adverse cardiovascular events,and improve their quality of life.