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瑞舒伐他汀对中年急性冠脉综合征患者PCI术后支架内再狭窄的影响
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| 篇名： | 瑞舒伐他汀对中年急性冠脉综合征患者PCI术后支架内再狭窄的影响 |
| TITLE： | |
| 摘要： | 目的：探讨瑞舒伐他汀对中年急性冠脉综合征（ACS）患者经皮冠动脉介入（PCI）术后支架内再狭窄的影响。方法：选取许昌市中心医院2016年3月－2017年4月收治的行PCI术的中年ACS患者400例为对象，按随机数字表法分为对照组和观察组，各200例。两组患者入院后均应用冠心病二级预防常规药物治疗，对照组患者术后口服硫酸氢氯吡格雷片75 mg，每日1次+阿司匹林肠溶片100 mg，每日1次+阿托伐他汀钙片20 mg，每晚1次；观察组患者术后口服硫酸氢氯吡格雷片75 mg，每日1次+阿司匹林肠溶片100 mg，每日1次+瑞舒伐他汀钙片10 mg，每晚1次。两组患者均连续治疗12个月。观察两组患者术前、术后1 d和术后1、3、6、12个月的血清三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、超敏C反应蛋白（hs-CRP）、白细胞介素35（IL-35）水平以及术后即刻和术后12个月的支架内最小管腔内径（MLD），并记录其支架内再狭窄、主要不良心血管事件（MACE）和药品不良反应（ADR）的发生情况。结果：对照组患者脱落14例，观察组脱落18例，共有368例患者完成本研究。术前或术后即刻，两组患者血清TG、TC、LDL-C、hs-CRP、IL-35水平和MLD比较，差异均无统计学意义（P＞0.05）；术后1 d，两组患者hs-CRP水平均较术前显著升高（P＜0.05）；术后1、3、6、12个月，两组患者血清TG、TC、LDL-C、hs-CRP水平均较术前显著下降，IL-35水平均较术前显著升高，且观察组患者血清TG、TC水平（术后1、3个月），LDL-C水平（术后3、6个月）和hs-CRP水平（术后1个月）均显著低于对照组，观察组IL-35水平（术后1个月）显著高于对照组（P＜0.05）。术后12个月，两组患者MLD均显著缩小，但观察组显著大于对照组（P＜0.05）。两组患者术后支架内再狭窄发生率以及MACE、ADR总发生率比较，差异均无统计学意义（P＞0.05）。结论：瑞舒伐他汀能有效改善中年ACS患者PCI术后的血脂水平和炎症因子水平，且短期内的效果较阿托伐他汀更优；该药亦可延缓该类患者PCI术后支架内再狭窄的进程，且作用较阿托伐他汀更明显；同时，瑞舒伐他汀不会增加MACE、ADR发生的风险，安全性良好。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of rosuvastatin on in-stent restenosis in middle-aged patients with acute coronary syndrome（ACS）after percutaneous coronary intervention （PCI）. METHODS： Totally 400 middle-aged ACS patients underwent PCI were selected from Xuchang Central Hospital during Mar. 2016 to Apr. 2017， and then divided into control group and observation group according to random number table， with 200 patients in each group. Both groups were given conventional drugs for secondary prevention of coronary heart disease. Control group were given Clopidogrel hydrogen sulfate tablets 75 mg， once a day+Aspirin enteric-coated tablets 100 mg， once a day+Atorvastatin calcium tablets 20 mg， once at bed time every day orally after PCI. Observation group was given Clopidogrel hydrogen sulfate tablets 75 mg， once a day+Aspirin enteric-coated tablets 100 mg， once a day+Rosuvastatin calcium tablets 10 mg， once at bed time every day orally after PCI. Both groups were treated for consecutive 12 months. The serum levels of TG， TC， LDL-C， hs-CRP and IL-35 were recorded in 2 groups before surgery， 1， 3， 6 and 12 months after surgery； in-stent minimum lumen diameter （MLD） was observed immediately after surgery and 12 months after surgery. The occurrence of in-stent restenosis， major adverse cardiovascular events （MACE） and adverse drug reaction （ADR） were recorded. RESULTS： Totally 14 patients dropped out from control group and 18 from observation group， and 368 patients completed the study. Before surgery and immediately after surgery， there was no statistical significance in the serum levels of TG， TC， LDL-C， hs-CRP IL-35 or MLD （P＞0.05）. One day after surgery， the levels of hs-CRP were increased significantly in 2 groups， compared with before surgery （P＜0.05）. One， three， six and twelve months after surgery， the serum levels of TG， TC， LDL-C and hs-CRP were decreased significantly in 2 groups， while the levels of IL-35 were increased significantly， compared with before surgery； and the serum levels of TG and TC （1 and 3 months after surgery）， LDL-C （3 and 6 months after surgery） and hs-CRP （1 month after surgery） in observation group were significantly lower than control group； the level of IL-35 in observation group （1 month after surgery） was significantly higher than control group （P＜0.05）. Twelve months after surgery， MLDs of 2 groups were decreased significantly， and observation group was significantly higher than control group （P＜0.05）. There was no statistical significance in the incidence of in-stent restenosis or the total incidence of MACE and ADR between 2 groups after surgery （P＞0.05）. CONCLUSIONS： Rosuvastatin can effectively improve the levels of blood lipid and inflammatory factor in meddle-aged patients with ACS after PCI， and its effect is better than that of atorvastatin. The drug can delay in-stent restenosis after PCI in these patients， which is better than the effect of atorvastatin. At the same time， rosuvastatin can not increase the risk of MACE and ADR with good safety. |
| 期刊： | 2019年第30卷第6期 |
| 作者： | 徐炳欣，兰丙欣，赵艳，郭树领，张云飞 |
| AUTHORS： | XU Bingxin，LAN Bingxin，ZHAO Yan，GUO Shuling，ZHANG Yunfei |
| 关键字： | 急性冠脉综合征；经皮冠状动脉介入术；中年患者；瑞舒伐他汀；阿托伐他汀；支架内再狭窄；主要不良心血管事件；药品不良反应 |
| KEYWORDS： | Acute coronary syndrome； Percutaneous coronary intervention； Middle-aged patients； Rosuvastatin； Atorvastatin； In-stent restenosis； Major adverse cardiovascular events； Adverse drug reaction |
| 阅读数： | 396 次 |
| 本月下载数： | 7 次 |
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