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尼可地尔联合瑞舒伐他汀对经皮冠状动脉介入治疗患者的心肌保护作用

Protective effect of nicorandil combined with rosuvastatin on myocardial tissue in patients who underwent percutaneous coronary intervention

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【作者】 李娟莫凡睿颜玉鸾赖沙毅楚罗湘

【Author】 LI Juan;MO Fan-rui;YAN Yu-luan;LAI Sha-yi;CHU Luo-xiang;Department of Cardiology,Liuzhou Worker’s Hospital;

【机构】 柳州市工人医院心内科

【摘要】 目的观察尼可地尔联合瑞舒伐他汀对冠状动脉介入治疗患者心肌保护作用。方法将68例择期进行经皮冠状动脉介入治疗术(PCI)的冠心病患者随机分为对照组36例和试验组32例。对照组术前予瑞舒伐他汀10 mg,qd,共3 d;试验组在对照组的基础上,术前加用尼可地尔5 mg,tid,共3 d。比较2组患者临床疗效、PCI术前和术后24,48 h血清高敏肌钙蛋白T(hs-cTnT)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的显效率分别为78.13%(25例/32例)和52.78%(19例/36例),差异有统计学意义(P<0.05)。PCI术前,试验组和对照组hs-cTnT水平分别为(36.56±15.35),(30.29±13.67)pg·mL-1,hs-CRP分别为(3.67±1.24),(3.53±1.32)mg·L-1,TNF-α分别为(6.54±2.42),(6.76±2.15)pg·mL-1,IL-10分别为(6.87±1.92),(7.02±1.85)pg·mL-1。PCI术后24 h,试验组和对照组hs-cTnT水平分别为(71.25±17.87),(82.65±18.34)pg·mL-1,hs-CRP分别为(9.48±2.35),(13.56±3.52)mg·L-1,TNF-α分别为(8.72±2.26),(10.65±3.16)pg·mL-1,IL-10分别为(13.55±4.51),(11.21±3.54)pg·mL-1;术后48 h试验组和对照组hs-cTnT水平分别为(60.56±15.64),(73.54±16.51)pg·mL-1,hs-CRP分别为(6.62±1.98),(10.24±2.84)mg·L-1,TNF-α分别为(7.56±1.86),(8.86±1.95)pg·mL-1,IL-10分别为(11.16±3.28),(9.76±3.11)pg·mL-1,术后24 h与术后48 h比较,差异均有统计学意义(均P<0.05)。试验组及对照组均没有出现明显的药物不良反应。结论 PCI术前尼可地尔联合瑞舒伐他汀可以降低炎性因子,提高IL-10,减轻PCI心肌损伤,安全性好。

【Abstract】 Objective To explore the protective effect of nicorandil combined with rosuvastatin on myocardial tissue in patients who underwent percutaneous coronary intervention(PCI).Methods A total of 68 patients with coronary heart diseases(CHD) who underwent PCI were randomly divided into control group(36 cases) and treatment group(32 cases).The control group was treated with rosuvastatin 10 mg once daily for 3 d before PCI.The treatment group was given nicorandil 5 mg three times daily for 3 d before PCI on the basis of control group.Levels of serum high-sensitive troponin T(hs-cTnT),high-sensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10) were measured before PCI and 24,48 h after PCI.Results The markedly effective rates in treatment group and control group were 78.13%(25/32),52.78%(19/36),with significant difference(P < 0.05).Before PCI,the levels of hs-cTnT in the treatment group and control group were(36.56 ± 15.35),(30.29 ± 13.67) pg·m L-1,hs-CRP were(3.67 ± 1.24),(3.53 ± 1.32) mg·L-1,TNF-α were(6.54 ± 2.42),(6.76 ± 2.15) pg·m L-1,IL-10 were(6.87 ± 1.92),(7.02 ± 1.85) pg·m L-1.At 24 h after PCI,the levels of hs-cTnT were(71.25 ± 17.87),(82.65 ± 18.34) pg · m L-1,hs-CRP were(9.48 ± 2.35),(13.56 ± 3.52)mg·L-1,TNF-α were(8.72 ± 2.26),(10.65 ± 3.16) pg·m L-1,IL-10 were(13.55 ± 4.51),(11.21 ± 3.54)pg·m L-1.At 48 h after PCI,the levels of hs-cTnT were(60.56 ± 15.64),(73.54 ± 16.51) pg·m L-1,hs-CRP were(6.62 ± 1.98),(10.24 ± 2.84) mg · L-1,TNF-α were(7.56 ± 1.86),(8.86 ± 1.95) pg·m L-1,IL-10 were(11.16 ± 3.28),(9.76 ± 3.11) pg · m L-1,and the differences of all the parameters above between the two groups were statistically significant(P < 0.05).No adverse drug reactions were found in both groups.Conclusion Nicorandil combined with rosuvastatin before PCI is able to reduce inflammatory factors,improve the level of IL-10 and alleviate myocardial injury,with high safety profile.

【基金】 国家自然科学基金资助项目(81160030);广西区卫计委基金资助项目(Z2015141)
  • 【文献出处】 中国临床药理学杂志 ,The Chinese Journal of Clinical Pharmacology , 编辑部邮箱 ,2017年22期
  • 【分类号】R541.4
  • 【被引频次】27
  • 【下载频次】105
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