摘要
目的探讨不同剂量瑞舒伐他汀对不稳定型心绞痛患者炎症因子、内皮功能及内脂素的影响及安全性。方法选择2011年2月—2015年5月温州医科大学附属第一医院收治的不稳定型心绞痛患者120例,按随机数字表法分为观察组和对照组,各60例。患者常规治疗,对照组口服瑞舒伐他汀10 mg/次,观察组口服瑞舒伐他汀20 mg/次,治疗疗程均为12个月。观察2组患者低氧诱导因子-1α(HIF-1α)、内脂素(Visfatin)、肿瘤细胞坏死因子(TNF-α)、血管性假血友病因子(v WF)、血浆内皮素(ET-1)、一氧化氮(NO)、超敏C反应蛋白(hs-CRP)表达水平,测定2组患者内皮功能。观察2组患者治疗期间心血管不良事件发生率,用药后不良反应。结果治疗后,2组患者血清中HIF-1α、Visfatin、TNF-α、hs-CRP、血清中v WF、ET-1的表达水平与治疗前相比均明显下降,且观察组下降程度均优于对照组,而2组患者血清中NO的表达水平与治疗前相比明显升高,且观察组升高程度优于对照组,差异均具有统计学意义(均P<0.05)。治疗后,两组患者础动脉内径值,充气后动脉内径值以及FMD与治疗前测量相比均明显增高,且观察组增高程度优于对照组,差异具有统计学意义(P<0.05)。观察组心血管不良事件总发生率显著低于对照组,差异具有统计学意义(P<0.05)。观察组肝功能异常发生率与对照组无统计学差异(P>0.05)。结论大剂量瑞舒伐他汀用于不稳定性心绞痛患者的综合临床疗效较好,在提高患者远期疗效方面较常规剂量明显,但不良反应发生率与使用剂量相关,因此临床应权衡使用。
Objective To compare the influence of different doses of Rosuvastatin on inflammatory factors, endothelial function and Visfatin levels in patients with unstable angina pectoris and its safety. Methods A total of 120 cases of un stable angina pectoris in our hospital between February, 2011 and May,2015 were enrolled and randomly divided into ob servation group and control group with 60 cases in each group. All patients received the routine therapy. The patients in the control group received orally 10 mg Rosuvastatin, 1 time a day,while the patients in the observation group received o rally 20 mg Rosuvastatin, 1 time a day,the course in both groups was 12 months. After the treatment, the levels of HIF- 1α,visfatin ,TNF-α, vWF, ET-1, NO and hs-CRP were tested. The endothelial function in both groups was determined. The incidence of cardiovascular adverse events during the treatment and adverse drug reactions were recorded. Results After the treatment, the serum alpha HIF-1, Visfatin, TNF alpha, hs-CRP, vWF and ET-1 levels in both groups decreased, more obviously in the observation group as compared with the control group. The serum NO level was increased in both groups, especially in the observation group, the difference between the two groups was significant（ P 〈 0.05 ）. After the treatment, the baseline artery diameter, lumen diameter during inflation and flow mediated dilation（FMD） were increased, especially in the observation group, the difference between the two groups was significant（ P 〈 0.05 ）. The incidence of adverse cardi- ovascular events in the observation group was significantly lower than that in the control group, and the difference was sta- tistical significant（P 〈 0.05 ）. The incidence of abnormal liver function in the observation group was higher than that in the control group,the difference was statistically significant （ P 〈 0. 05 ）. Conclusion The high-dose Rosuvastatin for un- stable angina pectoris have a better comprehensive clinical efficacy as compared with the routine dose, it can obviously im- prove the long-term efficacy,however, the incidence of adverse reactions is dose-related, and therefore the pros and cons should be weighed during the clinical use.
出处
《中华全科医学》
2016年第11期1835-1837,1866,共4页
Chinese Journal of General Practice
基金
2014年浙江省医药卫生科技计划项目(2014-KYA167)
