阿托伐他汀對(duì)合并睡眠呼吸暫停綜合征冠心病患者PCI術(shù)后血清炎癥細(xì)胞因子水平的影響

趙芳

【摘要】 目的：探討不同阿托伐他汀治療方案對(duì)合并睡眠呼吸暫停綜合征（SAS）冠心病患者經(jīng)皮冠狀動(dòng)脈介入治療（PCI）術(shù)后血清炎癥細(xì)胞因子水平的影響。方法：選取2016年1月-2017年12月筆者所在醫(yī)院收治的90例冠心病合并SAS患者作為研究對(duì)象，將其隨機(jī)分為A組和B組，每組45例。A組患者在PCI術(shù)前1周接受阿托伐他汀80 mg/d治療，術(shù)后將劑量調(diào)整至40 mg/d，4周后調(diào)至20 mg/d，持續(xù)治療20周。B組患者PCI術(shù)前不給予阿托伐他汀治療，術(shù)后給予阿托伐他汀40 mg/d治療，4周后將劑量調(diào)整至20 mg/d，持續(xù)治療20周。比較兩組PCI術(shù)后LVEDD、LVEF和IL-1β、IL-6、TNF-α表達(dá)水平。結(jié)果：PCI術(shù)后3 d，兩組LVEF和LVEDD比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;A組術(shù)后24周LVEF明顯高于B組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），而兩組LVEDD比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。A組患者在PCI術(shù)后1 d、4、24周時(shí)，血清IL-1β、IL-6和TNF-α表達(dá)水平均低于B組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：冠心病合并SAS患者在PCI治療前加載負(fù)荷劑量的阿托伐他汀，有助于改善心臟功能和機(jī)體免疫炎癥水平。

【關(guān)鍵詞】 阿托伐他汀; 睡眠呼吸暫停綜合征; 冠心病; 經(jīng)皮冠狀動(dòng)脈介入治療

doi：10.14033/j.cnki.cfmr.2019.21.016 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805（2019）21-00-03

Effect of Atorvastatin on Serum Inflammatory Cytokines Levels in Patients with Coronary Heart Disease Complicated with Sleep Apnea Syndrome after PCI/ZHAO Fang.//Chinese and Foreign Medical Research，2019，17（21）：-42

【Abstract】 Objective：To investigate the effects of different Atorvastatin regimens on serum inflammatory cytokines in patients with coronary heart disease complicated with sleep apnea syndrome（SAS） after percutaneous coronary intervention（PCI）.Method：From January 2016 to December 2017，90 patients with coronary heart disease combined with SAS admitted in our hospital were selected as research objects.They were randomly divided into group A and group B，with 45 cases in each group.Patients in group A received Atorvastatin 80 mg/d one week before PCI，and the dose was adjusted to 40 mg/d after PCI，then to 20 mg/d

after 4 weeks of continuous treatment for 20 weeks.Patients in group B were not treated with Atorvastatin before PCI，and were treated with atorvastatin 40 mg/d

after PCI.After 4 weeks，the dose was adjusted to 20 mg/d for 20 weeks.The expressions levels of LVEDD，LVEF，IL-1β、IL-6、TNF-α were compared between the two groups after PCI.Result：3 days after PCI，there were no significant differences in LVEF and LVEDD between the two groups（P>0.05）.The LVEF in group A was significantly higher than that in group B at 24 weeks after operation，the difference was statistically significant（P<0.05），but there was no significant difference in the comparison of LVEDD between the two groups（P>0.05）.The levels of serum IL-1β，IL-6 and TNF-α in group A were lower than those in group B at the 1day，4 and 24 weeks after PCI，the differences were statistically significant（P<0.05）.Conclusion：Loading dose of Atorvastatin before PCI in patients with coronary heart disease complicated with SAS can improve cardiac function and immune inflammation.

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（收稿日期：2019-05-21） （本文編輯：桑茹南）