摘要
目的探讨阿托伐他汀长期强化治疗对首诊冠心病(CHD)患者血脂及炎症指标的影响。方法选取2019年1月至2020年12月该院收治的首诊CHD患者204例(CHD组),另选60名健康体检的志愿者作为健康对照组(NC组)。CHD组进一步采用随机数字表法分为观察组和对照组,每组102例,对照组口服阿托伐他汀20 mg/d,观察组口服阿托伐他汀40 mg/d,均治疗6个月后评估疗效。检测并比较各组研究对象血脂水平、心功能指标及血清分拣蛋白(Sortilin)、枯草溶菌素转化酶9(PCSK9)、生长分化因子-15(GDF-15)、正五聚蛋白3(PTX3)水平。结果CHD组患者N末端B型脑钠肽前体、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、Sortilin、PCSK9、GDF-15、PTX3水平均明显高于NC组,高密度脂蛋白胆固醇(HDLC)明显低于NC组,差异均有统计学意义(P<0.05)。观察组和对照组患者治疗后血浆TG、TC、LDL-C、GDF-15、PTX3水平及左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)均明显降低,HDL-C、PCSK9水平及左心室射血分数(LVEF)均明显升高,且观察组患者治疗后血浆TG、TC、LDL-C、GDF-15、PTX3水平及LVESD、LVEDD均明显低于对照组,HDL-C、PCSK9水平及LVEF均明显高于对照组,差异均有统计学意义(P<0.05)。观察组和对照组患者治疗前后Sortilin水平、不良反应及主要不良心血管事件发生率比较,差异均无统计学意义(P>0.05)。结论阿托伐他汀强化降脂能有效调节首诊CHD患者血脂并保护心功能,下调GDF-15、PTX3表达,但可导致血清PCSK9水平升高。
Objective To investigate the influence of long-term intensive treatment on the blood lipids and inflammatory indicators in the patients with initially diagnosed coronary heart disease(CHD).Methods A total of 204 initially-diagnosed CHD patients(CHD group)admitted and treated in this hospital from January 2019 to December 2020 were selected,and other 60 healthy volunteers were selected as the healthy control group(NC group).The CHD group was further randomly divided into the observation group and control group with 102 cases in each group,and given oral atorvastatin 20 mg/d and 40 mg/d respectively.The effects were evaluated after 6-month treatment.The blood lipid levels,heart function indexes and levels of serum sorting protein(Sortilin),proprotein convertase subtilisin/kexin type 9(PCSK9),growth differentiation factor-15(GDF-15)and pentraxin 3(PTX3)were detect and compared among the groups.Results The levels of N-terminal B-type brain natriuretic peptide precursor(NT-proBNP),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),Sortilin,PCSK9,GDF-15 and PTX3 in the CHD group were significantly higher than those in the NC group,and the level of high-density lipoprotein cholesterol(HDLC)was significantly lower than that in the NC group,and the differences were statistically significant(P<0.05).The levels of plasmaTG,TC,LDL-C,GDF-15 and PTX3 l,LVESD and LVEDD after treatment in the observation group and control group were significantly reduced,the levels of HDL-C and PCSK9,and LVEF were significantly increased,moreover the levels of plasma TG,TC,LDL-C,GDF-15 and PTX3,LVESD and LVEDD after treatment in the observation group were significantly lower than those in the control group,the levels of HDL-C and PCSK9,and LVEF were significantly higher than those in the control group,and the differences were statistically significant(P<0.05);the Sortilin level before and after treatment,incidence rates of adverse reactions and major adverse cardiovascular events had no statistical differences between the observation group and control group(P>005).Conclusion The atorvastatin intensive lipid-lowering can effectively regulate blood lipids and protect the heart function,down-regulate the expression of GDF-15 and PTX3,but can lead to increase of serum PCSK9 level.
作者
刘彬
苏海龙
LIU Bin;SU Hailong(Department of Cardiovascular Medicine,Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China)
出处
《重庆医学》
CAS
2022年第16期2755-2761,共7页
Chongqing medicine
基金
中国管理科学研究院教育科学研究所科教创新研究项目(KJCX11150)。
作者简介
刘彬(1984-),主治医师,本科,主要从事心血管内科的研究;通信作者:苏海龙,E-mail:650066@hospital.cqmu.edu.cn。
