不同剂量血脂康对急性冠脉综合征患者PCI术后的影响

作者	单位
张林潮	广西医科大学第五附属医院柳州市人民医院心内科
杨进	广西医科大学第五附属医院柳州市人民医院心内科
孙立平	广西医科大学第五附属医院柳州市人民医院心内科
蒋芳勇	广西医科大学第五附属医院柳州市人民医院心内科

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中文摘要:

目的观察不同剂量血脂康对急性冠脉综合征(acute coronary syndrome,ACS)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后炎症因子和血脂变化的影响及安全性。方法将80例行择期PCI治疗的ACS住院患者随机分为大剂量组和常规剂量组,每组40例。两组在常规治疗基础上分别加服血脂康1.2、0.6 g,均于PCI术前当天开始服用,每天2次,疗程8周以上。检测两组术后1、4、8周高敏C反应蛋白(hs-CRP)和基质金属蛋白酶-9(MMP-9)的浓度;观察血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]及肝、肾功能变化;分析血脂与炎症因子的相关性;记录不良反应发生情况。结果与本组用药前比较,两组术后1、4、8周血清hs-CRP、MMP-9水平均下降,其中第8周差异有统计学意义(P<0.05),以大剂量组下降更明显(P<0.05);两组术后4、8周LDL-C水平均明显下降(P<0.05),大剂量组术后8周下降更明显(P<0.05)。术后8周大剂量组hs-CRP及MMP-9浓度变化与LDL-C下降程度呈正相关(r=0.828、0.922,P<0.05)。两组不良反应发生率及肝肾功能受损情况比较,差异无统计学意义(P>0.05)。结论血脂康能降低ACS患者血清hs-CRP、MMP-9浓度及LDL-C水平,大剂量较常规剂量作用更为明显;其炎症因子降低程度与降脂幅度有关。

英文摘要:

Objective To study the effects Xuezhikang(XZK) at different doses on inflammatory factors and blood lipids of patients suffering from acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI) and to discuss their safety.Methods Eighty ACS in patients receiving selective PCI treatment were randomly assigned to two groups,40 cases in the normal dose group and 40 cases in the large dose XZK group.Besides routine therapy,all patients took XZK at the daily dose of 1.2 and 0.6 g,twice daily.They started XZK from the very day of PCI operation.The therapeutic course for all was more than 8 weeks.The levels of high sensitivity C reactive protein(hs-CRP) and matrix metalloproteinase-9(MMP-9) were detected in the two groups 1 week,4 and 8 weeks after operation.The levels of TC,TG,HDL-C,LDL-C,changes of liver and renal functions were observed.The correlation between blood lipids and inflammatory factors were analyzed.The adverse reaction was recorded.Results Compared with before medication,the serum levels of hs-CRP and MMP-9 decreased in the two groups 1 week,4 and 8 weeks after operation,with statistical difference shown in the levels at the 8th week(P<0.05).The decrease was more obvious in the large dose XZK group(P<0.05).The LDL-C level obviously decreased in the two groups 4 and 8 weeks after operation(P<0.05).The decrease was more obvious in the large dose XZK group at the 8th week(P<0.05).The levels of hs-CRP and MMP-9 were positively correlated with the decrease degree of LDL-C in the large dose XZK group at the 8th week(r=0.828,0.922,P<0.05).There was no significant difference in the occurrence of adverse reaction,hepatic or renal functions between the two groups.Conclusions XZK could lower the serum levels of hs-CRP,MMP-9,and LDL-C.More obvious effects were obtained in the large dose XZK group.The decrease degree of inflammatory factors was correlated with the decrease extent of blood lipids.

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