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阿托伐他汀联合曲美他嗪对不稳定型心绞痛患者经皮冠状动脉介入治疗围手术期心肌损伤及炎症介质的影响

Effects of atorvastatin combined with trimetazidine on myocardial injury and inflammatory mediator in unstable angina patients during perioperative of percutaneous coronary intervention.

作者信息

Hao J, Du H, Li W-W, Zhao Z-F, Liu F, Lu J-C, Yang X-C, Cui W

机构信息

Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

出版信息

Eur Rev Med Pharmacol Sci. 2015 Dec;19(23):4642-6.

PMID:26698263
Abstract

OBJECTIVE

To investigate the effects of atorvastatin combined with trimetazidine on periprocedural myocardial injury and serum inflammatory mediators in unstable angina pectoris (UAP) patients following percutaneous coronary intervention (PCI) treatment.

PATIENTS AND METHODS

90 patients with UAP treated with conventional medications and PCI were recruited and were randomly divided into the control group and the experimental group. The control group had 42 patients were treated with atorvastatin alone, while the experimental group had 48 cases treated with atorvastatin combined with trimetazidine. All the patients were checked the preoperative 24h and postoperative 24h PCI concentrations of cardiac troponin I (cTnI), hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), serum interferon-γ (IFN-γ) and interlukin-10 (IL-10).

RESULTS

At the pre-PCI stage, every serum factors was no significant difference. 24 hours after the PCI intervention, the occurence of abnormal cTnI level in the experimental group was remarkable reduced than the control group. In the experimental group, the serum levels of TNF-α and IFN-γ significantly decreased (p < 0.05); while IL-10 was increased. In the control group, all the mediators were increased significantly except the hs-CRP (p < 0.05).

CONCLUSIONS

No unexpected symptom was found in patients with large dose atorvastatin combined with large dose trimetazidine. The administration of conventional medications together with the atorvastatin plus trimetazidine were able to reduce the prevalence of postoperative myocardial injury.

摘要

目的

探讨阿托伐他汀联合曲美他嗪对不稳定型心绞痛(UAP)患者经皮冠状动脉介入治疗(PCI)围手术期心肌损伤及血清炎症介质的影响。

患者与方法

选取90例接受常规药物治疗及PCI的UAP患者,随机分为对照组和试验组。对照组42例患者仅接受阿托伐他汀治疗,试验组48例患者接受阿托伐他汀联合曲美他嗪治疗。所有患者均于PCI术前24小时及术后24小时检测心肌肌钙蛋白I(cTnI)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、血清干扰素-γ(IFN-γ)及白细胞介素-10(IL-10)的浓度。

结果

PCI术前阶段,各项血清因子无显著差异。PCI干预24小时后,试验组cTnI水平异常发生率显著低于对照组。试验组中,TNF-α和IFN-γ血清水平显著降低(p < 0.05);而IL-10升高。对照组中,除hs-CRP外,所有介质均显著升高(p < 0.05)。

结论

大剂量阿托伐他汀联合大剂量曲美他嗪治疗的患者未发现意外症状。常规药物联合阿托伐他汀加曲美他嗪给药能够降低术后心肌损伤的发生率。

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