Department of Cardiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
General Family Medicine, Hangzhou Xiacheng District Community Health Service Center, Hangzhou, China.
Minerva Med. 2019 Apr;110(2):101-106. doi: 10.23736/S0026-4806.18.05633-1. Epub 2018 Apr 24.
The aim of this study was to analyze the changes of interleukin-6 (IL-6), C-reactive protein (CRP), blood lipids and myocardial indexes after treatment of patients with acute myocardial infarction (AMI) with intensive atorvastatin and interventional therapy, and its clinical significance.
A total of 78 patients diagnosed with AMI in our hospital from March 2016 to February 2017 were selected and divided into treatment group (N.=39) and control group (N.=39). Patients in treatment group were treated with intensive atorvastatin based on conventional therapy before and after percutaneous coronary intervention (PCI), while those in control group were treated with conventional therapy before and after PCI. The levels of serum IL-6, CRP, blood lipids (total cholesterol [TC], triglyceride [TG], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) and myocardial enzyme indexes (troponin T [TnT] and creatine kinase-MB [CK-MB]) at different time points were detected. The correlations among serum CRP, TC, and TnT in treatment group before treatment were detected using the linear regression analysis, and changes in serum inflammatory factors, blood lipids and myocardial enzyme indexes in treatment group before and after treatment were analyzed.
There were no statistically significant differences in demographics and clinical data between treatment group and controls (P>0.05). There were no significant differences, either, in levels of serum IL-6 and CRP before treatment between treatment group and control group, but they were decreased after treatment, and the curative effect in treatment group was significantly superior to that in control group. The differences were statistically significant (P<0.05). There were no significant differences in serum TC, TG, HDL-C and LDL-C levels before treatment between the two study groups. TC, TG and LDL-C were significantly decreased and HDL-C was significantly increased after treatment compared to before treatment. TnT and CK-MB were significantly increased at 24 hours after treatment (P<0.05). At 1 week, TnT was still higher, whereas CK-MB has returned to normal; at 2 weeks, they were both decreased. The curative effect in the treatment group was significantly superior to that in control group. CRP (r=0.793, P<0.001) and TC (r=0.668, P<0.001) were found to be positively correlated with TnT. The levels of serum inflammatory factors and blood lipids in the treatment group before treatment and at 24 hours, 1 week, and 2 weeks showed a decreasing trend, and TnT was increased at first, and then decreased.
The application of intensive atorvastatin for AMI patients, especially before PCI, has high safety, which can effectively reduce levels of serum inflammatory factors and blood lipids, protect myocardial cells after PCI and avoid injury.
本研究旨在分析强化阿托伐他汀与介入治疗急性心肌梗死（AMI）患者后白细胞介素 6（IL-6）、C 反应蛋白（CRP）、血脂和心肌指标的变化及其临床意义。
选取我院 2016 年 3 月至 2017 年 2 月期间确诊为 AMI 的 78 例患者，分为治疗组（n=39）和对照组（n=39）。治疗组在经皮冠状动脉介入治疗（PCI）前后采用强化阿托伐他汀治疗，对照组在 PCI 前后采用常规治疗。检测不同时间点血清 IL-6、CRP、血脂（总胆固醇[TC]、甘油三酯[TG]、高密度脂蛋白胆固醇[HDL-C]和低密度脂蛋白胆固醇[LDL-C]）和心肌酶指标（肌钙蛋白 T [TnT]和肌酸激酶同工酶-MB [CK-MB]）水平。采用线性回归分析治疗组治疗前 CRP、TC 与 TnT 之间的相关性，并分析治疗组治疗前后血清炎症因子、血脂和心肌酶指标的变化。
治疗组与对照组患者的人口统计学和临床资料无统计学差异（P>0.05）。治疗组和对照组治疗前血清 IL-6 和 CRP 水平无统计学差异，但治疗后均降低，治疗组疗效明显优于对照组，差异有统计学意义（P<0.05）。两组患者治疗前血清 TC、TG、HDL-C 和 LDL-C 水平无统计学差异。治疗后 TC、TG 和 LDL-C 明显降低，HDL-C 明显升高。与治疗前相比，治疗后 24 小时 TnT 和 CK-MB 明显升高（P<0.05）。治疗后 1 周 TnT 仍升高，CK-MB 已恢复正常；治疗后 2 周，两者均下降。治疗组疗效明显优于对照组。CRP（r=0.793，P<0.001）和 TC（r=0.668，P<0.001）与 TnT 呈正相关。治疗组治疗前及治疗后 24 小时、1 周、2 周血清炎症因子和血脂水平呈下降趋势，TnT 先升高后降低。
强化阿托伐他汀治疗 AMI 患者，特别是在 PCI 前，具有较高的安全性，能有效降低血清炎症因子和血脂水平，保护 PCI 后心肌细胞，避免损伤。
