辛伐他汀对冠脉支架术后再狭窄和血脂及炎症因子的影响

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目的探讨辛伐他汀对冠心病患者冠脉支架植入术后再狭窄以及对血脂和高敏C-反应蛋白(hs-CRP)水平的影响。方法118例冠心病冠脉支架植入术患者,随机分为辛伐他汀治疗组(n=62)和对照组(n=56),对照组常规采用肠溶阿司匹林片(100mg/d)和波立维片(75mg/d)口服,治疗组在此基础上每晚加用辛伐他汀片40mg,疗程均为6个月,疗程结束后随即冠脉造影,比较两组支架植入术后再狭窄率的差别,以及两组患者血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三脂(TG)和hs-CRP水平。结果治疗组冠脉支架术后再狭窄率明显低于对照组(P<0.01),无论是普通支架亚组还是雷帕霉素洗脱支架亚组(DES)均有相似的结果(P均<0.01),术后6月,治疗组血清TC、LDL-C、TG和hS-CRP水平均明显低于对照组(P<0.01和0.05),而HDL-C却明显高于对照组(P<0.05),两组均无死亡病例。结论辛伐他汀(40mg/d)可明显降低冠脉支架术后再狭窄率,同时具有良好的调脂和减轻炎症反应的作用,安全性良好。 Objective To investigate the effect of simvastatin on restenosis after coronary stent implantation and on serum lipid and high-sensitivity C-reactive protein (hs-CRP) in patients with coronary heart disease. Methods A total of 118 patients with coronary artery disease undergoing coronary stenting were randomly divided into simvastatin treatment group (n = 62) and control group (n = 56). The control group was given routine enteric-coated aspirin tablets (100mg / d) On the basis of this, 40 mg of simvastatin tablets were added to the treatment group on a daily basis for 6 months. Coronary angiography was performed immediately after the end of treatment. Restenosis after stent implantation was compared between the two groups (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG) and hs-CRP in the two groups. Results The rate of restenosis after coronary stenting in the treatment group was significantly lower than that in the control group (P <0.01). Similar results were obtained both in the common stent group and the DES-DES group (all P < 0.01). After 6 months, the levels of TC, LDL-C, TG and hS-CRP in the treatment group were significantly lower than those in the control group (P <0.01 and 0.05), while the levels of HDL-C in the treatment group were significantly higher than those in the control group 0.05), no deaths were found in both groups. Conclusion Simvastatin (40mg / d) can significantly reduce the rate of restenosis after coronary stenting, and has good lipid-lowering and anti-inflammatory effects, with good safety.
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