不同他汀类药物联合比伐卢定对急性心梗患者PCI术后心肌功能、血凝状态及炎症因子水平的影响

Effect of different statins combined with bivalirudin on myocardial function, blood coagulation status and inflammatory factor levels in patients with acute myocardial infarction after percutaneous coronary intervention

目的比较不同他汀类药物联合比伐卢定对急性心梗患者PCI术后心肌功能、血凝状态及炎症因子水平的影响。方法选择比较北京安贞医院2012年9月至2016年2月收治的80例急性心肌梗死住院患者作为研究对象,按随机数表法分为A组(n=42)和B组(n=38)。两组患者均行PCI术,术前静脉给予注射用比伐卢定。A组于术前应用瑞舒伐他汀钙片,B组应用阿托伐他汀钙片。比较两组患者PCI术前后的心脏射血分数(EF值)、二尖瓣血流舒张与收缩期最大流速的比值(E/A)、纤维蛋白原(Fg)、D二聚体(D-D)、超敏C反应蛋白(hs-CRP)和白介素6(IL-6)。结果两组患者术前的EF、E/A、Fg、D-D、hs-CRP、IL-6水平比较差异均无统计学意义(P>0.05);A组患者术后EF、E/A分别为(58.60±12.71)%、(0.95±0.41),高于B组的(52.93±10.80)%、(0.84±0.37),Fg、D-D、hs-CRP、IL-6分别为(3.64±0.81)g/L、(0.41±0.20)mg/L、(23.65±3.82)mg/L、(17.61±3.22)U/L,低于B组的(4.02±0.63)g/L、(0.81±0.42)mg/L、(31.61±4.40)mg/L、(26.00±2.73)U/L,差异均有统计学意义(P<0.05)。结论与阿托伐他汀比较,瑞舒伐他汀联合比伐卢定可更有效改善急性心肌梗死患者PCI术后心肌功能及血凝状态,并使炎症因子得到有效抑制,有利于改善患者的预后。

Objective To compare the effects of different statins combined with bivalirudin on myocardial function, blood coagulation status and inflammatory factor levels in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI). Methods Eighty patients with AMI who hospitalized in Beijing Anzhen Hospital from September 2012 and February 2016 were selected as research subjects. They were divided into group A(n=42) and group B(n=38) according to the random number table. All patients in both groups underwent PCI,which were treated with intravenous injection of bivalirudin before operation. Group A applied Rosuvastatin Calcium Tablets before operation, while group B applied Atorvastatin Calcium Tablets. The ejection fraction(EF value), ratio of mitral blood flow diastolic and systolic maximum flow velocity(E/A ratio), fibrinogen(Fg), D-dimer(D-D) and high-sensitivity C reactive protein(hs-CRP), interleukin 6(IL-6) were compared between the two groups before and after PCI.Results There were no significant differences in EF, E/A, Fg, D-D, hs-CRP and IL-6 levels between the two groups before operation(P>0.05). After operation, EF and E/A in group A were respectively(58.60±12.71)%,(0.95±0.41), which were significantly higher than those in group B of(52.93 ± 10.80)%,(0.84 ± 0.37). After operation, Fg, D-D, hs-CRP and IL-6 in group A were respectively(3.64±0.81) g/L,(0.41±0.20) mg/L,(23.65±3.82) mg/L,(17.61±3.22) U/L, which were significantly lower than those in group B of(4.02±0.63) g/L,(0.81±0.42) mg/L,(31.61±4.40) mg/L,(26.00±2.73) U/L, P<0.05. Conclusion Compared with atorvastatin, rosuvastatin combination with bivalirudin can more effectively improve the myocardial function and blood coagulation status in patients with acute myocardial infarction after PCI, and inhibit inflammatory factors, which is beneficial for the improvement of prognosis.