实用老年医学

实用老年医学 ›› 2023, Vol. 37 ›› Issue (3): 265-269.doi: 10.3969/j.issn.1003-9198.2023.03.013

• 临床研究 • 上一篇    下一篇

强化瑞舒伐他汀治疗对老年急性冠脉综合征病人PCI术后炎性衰老相关指标的影响及临床疗效

姜磊, 贾志强, 俞建, 李晓庆, 张冬梅, 黄菁菁   

  1. 210031 江苏省南京市,南京医科大学第四附属医院老年医学科(姜磊,张冬梅,黄菁菁);
    210011 江苏省南京市,南京医科大学第二附属医院心血管内科(贾志强,俞建);
    211166 江苏省南京市,南京医科大学(李晓庆)
  • 收稿日期:2022-04-11 出版日期:2023-03-20 发布日期:2023-03-13
  • 通讯作者: 黄菁菁,Email:jingjinghuang@njmu.edu.cn
  • 基金资助:
    江苏省卫生健康委员会老年健康科研课题项目(LK2021030);南京医科大学科技发展基金一般项目(NMUB2019058,NMUB2020047)江苏省高等学校大学生创新创业训练计划(202110312082Y)

Effects of intensive rosuvastatin treatment on the inflamm-aging related indexes and clinical efficacy in elderly patients with acute coronary syndrome receiving percutaneacs coronary intervention

JIANG Lei, JIA Zhi-qiang, YU Jian, LI Xiao-qing, ZHANG Dong-mei, HUANG Jing-jing   

  1. Department of Geriatrics, the Fourth Affilliated Hospital of Nanjing Medical University, Nanjing 210031, China(JIANG Lei, ZHANG Dong-mei, HUANG Jing-jing);
    Department of Cardiovascular Medicine, the Second Affilliated Hospital of Nanjing Medical University, Nanjing 210011, China(JIA Zhi-qiang, YU Jian);
    Nanjing Medical University, Nanjing 211166, China(LI Xiao-qing)
  • Received:2022-04-11 Online:2023-03-20 Published:2023-03-13
  • Contact: HUANG Jing-jing, Email: jingjinghuang@njmu.edu.cn

PDF (PC)

864

摘要： 目的 探讨强化瑞舒伐他汀治疗对老年急性冠脉综合征(acute coronary syndrome,ACS)病人经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后炎性衰老相关指标水平的影响及临床疗效。方法 选择2018年6月至2020年6月我院收治的128例老年ACS病人,随机分为对照组和观察组,每组64例。2组病人均急诊行PCI,其中对照组术前给予常规瑞舒伐他汀10 mg治疗,观察组给予强化瑞舒伐他汀20 mg治疗。比较2组病人治疗前后血管内皮生长因子(vascular endothelial growth factor,VEGF)、血管细胞黏附因子-1(vascular cell adhesion molecule-1,VCAM-1)及色素上皮衍生因子(pigment epithelium derived factor,PEDF)水平变化情况。比较2组病人斑块大小、厚度和颈动脉内膜中层厚度(IMT)及斑块钙化积分情况。随访12个月,观察2组病人主要不良心血管事件发生情况。结果 PCI前,2组VEGF、VCAM-1、PEDF水平差异均无统计学意义(P>0.05)。治疗后2组VEGF、VCAM-1水平明显下降,且观察组较对照组下降更明显(P＜0.05);与治疗前相比,对照组治疗后PEDF水平无明显变化(P＞0.05),观察组治疗后PEDF水平上升(P＜0.05)。PCI术后,2组病人斑块大小、厚度,以及IMT、斑块钙化积分均减小,且观察组减小更明显(P＜0.05)。随访12个月,观察组主要不良心血管事件发生率明显低于对照组(4.69%比20.31%,P＜0.05)。结论 强化瑞舒伐他汀治疗PCI术后老年ACS病人可有效降低VEGF和VCAM-1水平,改善PEDF水平,增加粥样斑块的稳定性,减轻颈动脉粥样硬化,对ACS的防治及预后具有重要意义。

关键词: 瑞舒伐他汀, 急性冠脉综合征, 炎性衰老, 血管内皮生长因子

Abstract: Objective To investigate the effect of intensive rosuvastatin treatment on the inflamm-aging and the efficacy in the elderly patients with acute coronary syndrome (ACS) receiving percutaneacs coronary intervention(PCI). Methods A total of 128 elderly ACS patients admitted to our hospital from June 2018 to June 2020 were randomly divided into control group and observation group, with 64 cases in each group. Both groups were treated with PCI in emergency, and rosuvastatin 10 mg was given to the control group and intensive rosuvastatin 20 mg was given to the observation group. The levels of vascular endothelial growth factor (VEGF), vascular cell adhesion molecule-1 (VCAM-1) and pigment epithelium derived factor (PEDF) were detected and compared between the two groups. The size and thickness of plaque, intima-media thickness (IMT) and calcification score were compared between the two groups. After 12 months of follow-up, the major adverse cardiovascular events (MACE) in the two groups were observed. Results There were no significant differences in the levels of VEGF, VCAM-1 and PEDF between the two groups before PCI. After PCI, the levels of VEGF and VCAM-1 in both groups decreased significantly, especially in the observation group (P<0.05); The level of PEDF increased significantly in the observation group (P<0.05), but there was no significant change in the control group (P>0.05). The size and thickness of plaque, IMT and plaque calcification score in both groups decreased significantly after PCI, especially in the observation group (P<0.05). After 12 months of follow-up, the incidence rate of MACE in the observation group was significantly lower than that in the control group (4.69% vs 20.31%, P<0.05). Conclusions Intensive rosuvastatin treatment can effectively reduce the levels of VEGF and VCAM-1, improve the level of PEDF, increase the stability of atherosclerotic plaque, and reduce the carotid atherosclerosis in the elderly patients with ACS, which is of great significance for the prevention, treatment and prognosis of ACS.

Key words: rosuvastatin, acute coronary syndrome, inflamm-aging, vascular endothelial growth factor

中图分类号: