摘要
目的 探讨阿利西尤单抗联合瑞舒伐他汀对急性心肌梗死(AMI)患者PCI术后冠脉微循环、炎症及心功能的影响。方法 前瞻性选取在2020年1月至2021年12月华润武钢总医院接受PCI治疗的AMI患者120例,随机数字表法分为对照组与观察组,每组60例。两组术后均予以吡格雷片、阿司匹林等常规治疗;此外,对照组予以瑞舒伐他汀钙片口服(10 mg/次,1次/d),观察组在对照组基础上予以阿利西尤单抗75 mg,皮下注射,每2周进行1次,两组均连续用药6个月。治疗前和治疗6个月后,检测两组血脂[总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)]、炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)]、冠脉血流分级和心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)以及二尖瓣口舒张早期与晚期峰值血流速度比值(E/A)],并记录两组主要不良心血管事件(MACE)发生情况。结果 治疗6个月后,观察组总胆固醇、甘油三酯、LDL-C及hs-CRP、IL-6、MMP-9水平分别为(3.28±0.56) mmol/L、(1.95±0.76) mmol/L、(1.42±0.37) mmol/L、(1.29±0.25) mg/L、(12.36±3.16) ng/L、(33.41±5.69) ng/mL,均显著低于对照组[(3.69±0.63) mmol/L、(2.24±0.68) mmol/L、(1.86±0.47) mmol/L、(1.41±0.29) mg/L、(16.78±3.39) ng/L、(37.12±6.29) ng/mL],差异均有统计学意义(P<0.05)。观察组在6个月时的冠脉血流分级明显优于对照组,差异均有统计学意义(P<0.05)。治疗6个月后,观察组LVEF、LVESD、E/A为(62.67±4.95)%、(33.78±3.29) mm、1.42±0.31,均优于对照组[(58.46±4.87)%、(37.65±5.24) mm、1.29±0.29],差异均有统计学意义(P<0.05)。随访6个月内,观察组MACE发生率为12.28%,显著低于对照组(29.31%),差异有统计学意义(P<0.05)。结论 阿利西尤单抗联合瑞舒伐他汀用于AMI患者PCI术后治疗,可更好地调节血脂,抑制炎症反应,改善冠脉微循环和心功能,降低MACE发生率。
Objective To investigate the effect of alisiewab combined with rosuvastatin on coronary microcirculation, inflammation and cardiac function in patients with acute myocardial infarction(AMI) after PCI. Methods A total of 120 patients with AMI who underwent PCI in Huarun Wugang General Hospital from January 2020 to December 2021 were divided into control group and observation group according to the random number table, with 60 cases in each group. Both groups were given conventional treatment such as clopidogrel tablets and aspirin after operation. In addition, the control group was given rosuvastatin calcium tablets orally(10 mg/time, 1 time/d), and the observation group was given alisiewab 75 mg subcutaneously on the basis of the control group, once every 2 weeks;both groups were treated for 6 consecutive months. Before and after 6 months of treatment, blood lipids [total cholesterol, triglyceride, low-density lipoprotein cholesterol(LDL-C)], inflammatory factors [high-sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6), matrix metalloproteinases-9(MMP-9)], coronary blood flow classification and cardiac function indexes [left ventricular ejection fraction(LVEF), left ventricular end systolic diameter(LVESD), and early to late diastolic mitral valve flow velocity ratio(E/A)] were detected in the two groups, and the occurrence of major adverse cardiovascular events(MACE) in the two groups was recorded. Results After 6 months of treatment, the levels of total cholesterol, triglyceride, LDL-C, hs-CRP, IL-6, MMP-9 in the observation group were(3.28±0.56) mmol/L,(1.95±0.76) mmol/L,(1.42±0.37) mmol/L,(1.29±0.25) mg/L,(12.36±3.16) ng/L,(33.41±5.69) ng/mL, which were significantly lower than those in the control group [(3.69±0.63) mmol/L,(2.24±0.68) mmol/L,(1.86±0.47) mmol/L,(1.41±0.29) mg/L,(16.78±3.39) ng/L,(37.12±6.29) ng/mL], the differences were statistically significant(P<0.05). The coronary blood flow classification of the observation group at 6 months was significantly better than that of the control group, the difference was statistically significant(P<0.05). After 6 months of treatment, LVEF, LVESD, E/A in the observation group were(62.67±4.95)%,(33.78±3.29) mm, 1.42±0.31, which were better than those in the control group [(58.46±4.87)%,(37.65±5.24) mm, 1.29±0.29], the differences were statistically significant(P<0.05). Within six months of follow-up, the incidence of MACE in the observation group was 12.28%, which was significantly lower than that in the control group(29.31%), and the difference was statistically significant(P<0.05). Conclusion The combination of alisiew monoclonal antibody and rosuvastatin in the treatment of AMI patients after PCI can better regulate blood lipids, inhibit inflammatory response, improve coronary microcirculation and cardiac function, and reduce the incidence of MACE.
作者
赵娟
李伟
郑永强
曾肃友
ZHAO Juan;LI Wei;ZHENG Yong-qiang(Department of Cardiology,Huarun Wugang General Hospital,Wuhan Hubei 430080,China;Department of Cardiology,The Second People's Hospital of Three Gorges University,Yichang Hubei 443000,China)
出处
《临床和实验医学杂志》
2022年第24期2606-2610,共5页
Journal of Clinical and Experimental Medicine
基金
湖北省卫生健康委科研项目(编号:WJ2019M065)。
