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瑞舒伐他汀联合替罗非班对急性冠状动脉综合征并发糖尿病患者PCI术后血清炎症因子水平和肾功能的影响
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| 篇名： | 瑞舒伐他汀联合替罗非班对急性冠状动脉综合征并发糖尿病患者PCI术后血清炎症因子水平和肾功能的影响 |
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| 摘要： | 目的：探讨瑞舒伐他汀联合替罗非班对急性冠状动脉综合征并发糖尿病患者经皮冠状动脉介入治疗（PCI）术后血清炎症因子水平和肾功能的影响。方法：选取我院2014年4月－2015年3月在心内科行PCI术的120例急性冠状动脉综合征并发糖尿病患者，按随机数字表法分为对照组和观察组，每组60例。除常规治疗外，对照组患者术后口服瑞舒伐他汀钙片（每日10 mg，连续7 d），观察组患者术前、术后口服瑞舒伐他汀钙片（术前20 mg；术后每日10 mg，连续7 d），术中给予盐酸替罗非班氯化钠注射液[静脉注射10 μg/kg，0.15 μg/（kg·min）静脉泵入36 h]。比较两组患者临床疗效，术前和术后24、72 h的血清炎症因子[肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）和IL-10]水平、肾功能指标[血清肌酐（Scr）、胱抑素C（CysC）、肾小球滤过率（eGFR）]变化，以及造影剂肾病发生率和随访1年的心血管事件发生情况。结果：两组患者治疗前基线资料差异无统计学意义（P＞0.05）。观察组患者治疗后完全缓解例数和总有效率明显高于对照组（P＜0.05），无效例数明显低于对照组（P＜0.05）。与术前比较，两组患者术后24、72 h的血清炎症因子水平均明显降低，对照组患者术后24、72 h和观察组患者术后24 h的Scr和CysC水平明显升高，eGFR水平明显降低，观察组患者术后72 h仅CysC水平明显升高，以上差异均有统计学意义（P＜0.05）。观察组患者的血清炎症因子和肾功能指标改善效果均较对照组更明显（P＜0.05），造影剂肾病发生率明显低于对照组（P＜0.05）；随访1年的心绞痛发生率和心血管事件总发生率明显低于对照组（P＜0.05）。结论：瑞舒伐他汀联合替罗非班可促进急性冠状动脉综合征并发糖尿病患者PCI术后的肾功能恢复，降低血清炎症因子水平，降低造影剂肾病发生率和治疗后心血管事件发生率，与瑞舒伐他汀单用存在差异。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of rosuvastatin combined with tirofiban on serum inflammatory factors and renal function in acute coronary syndrome patients with diabetes after percutaneous coronary intervention （PCI）. METHODS： A total of 120 acute coronary syndrome patients with diabetes receiving PCI selected from cardiology department of our hospital during Apr. 2014-Mar. 2015 were divided into control group and observation group according to random number table， with 60 cases in each group. Except for routine treatment， control group was given Rosuvastatin calcium tablets orally after surgery （10 mg each day， for consecutive 7 d）； observation group was given Rosuvastatin calcium tablets orally before and after surgery （20 mg before surgery； 10 mg each day after surgery， for consecutive 7 d）， and then given Tirohydrochloric acid sodium chloride injection during surgery [10 μg/kg intravenously， 0.15 μg/（kg·min） with intravenous pump for 36 h]. Clinical efficacies of 2 groups were compared. The changes of serum inflammatory factors （TNF-α， IL-6， IL-10） and renal function indexes （Scr， CysC， eGFR）， the incidence of radiographic contrast nephropathy were compared before surgery and 24， 72 h after surgery. The occurrence of cardiovascular events was followed up for one year. RESULTS： There were no statistical significance in baseline information between 2 groups before treatment （P＞0.05）. The number of complete remission case and total response rate in observation group were increased significantly higher than control group （P＜0.05）， while number of invalid cases was significantly lower than control group （P＜0.05）. Compared with before surgery， the levels of serum inflammation factor in 2 groups were decreased significantly 24， 72 h after surgery， while the levels of Scr and CysC were increased significantly in control group 24， 72 h after surgery and in observation group 24 h after surgery； the level of eGFR was decreased significantly， while the level of CysC was increased significantly in observation group 72 h after surgery， with statistical significance （P＜0.05）. The improvement of serum inflammation factors and renal function indexes in observation group were more significant than control group （P＜0.05）； the incidence of radiographic contrast nephropathy was significantly lower than control group （P＜0.05）. The incidence of 1-year angina pectoris and total incidence of cardiovascular events were significantly lower than control group （P＜0.05）. CONCLUSIONS： Rosuvastatin combined with tirofiban can promote the recovery of renal function in acute coronary syndrome patients with diabetes after PCI， reduce the levels of serum inflammatory factors and decrease the incidence of radiographic contrast nephropathy and post-treatment cardiac events. Its effects are different from rosuvastatin alone. |
| 期刊： | 2018年第29卷第5期 |
| 作者： | 杨建军，庞小华，张建明，米庆，牟华明 |
| AUTHORS： | YANG Jianjun，PANG Xiaohua，ZHANG Jianming，MI Qing，MOU Huaming |
| 关键字： | 替罗非班；瑞舒伐他汀；糖尿病；冠状动脉综合征；经皮冠状动脉介入治疗；肾功能；炎症因子 |
| KEYWORDS： | Tirofiban； Rosuvastatin； Diabetes； Coronary syndrome； PCI； Renal function； Inflammatory factors |
| 阅读数： | 313 次 |
| 本月下载数： | 8 次 |
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