论文部分内容阅读
目的探讨阿魏酸钠对冠脉支架术后患者机体的炎症因子变化,从而为临床心内科医师开展术后预防提供参考意见。方法选60例需要行支架植入术的急性冠脉综合征的患者,时间从2014年3月1日~2015年3月31日,完成入院相关评估,随机分为治疗组(35例),给予常规治疗加用阿魏酸钠400 mg/d;对照组(25例),给予常规治疗的基础上加用安慰剂;采集两组患者术前6 h、术后1 h、3 h、6 h、12 h外周血液,检测血浆中NO、hs-CRP、IL-18及IL-10,进行IL-18/IL-10分析;在支架植入术后1年时复查冠脉造影比较两组冠脉再狭窄的发生率,对实验结果进行统计学分析。结果术前两组患者6 h hs-CRP、IL-18及IL-10水平比较差异无统计学意义;术后两组患者6 h hs-CRP、IL-18及IL-10较术前均升高,但差异无统计学意义;实验组治疗1 h、3 h、6 h、12 h后血清hs-CRP、IL-18水平降低,组内差异有统计学意义(P<0.05);IL-10水平升高,组内差异也具有统计学意义,可能和阿魏酸钠作用相关,IL-18/IL-10下降,说明阿魏酸钠的治疗的作用明显,差异有统计学意义;对照组治疗前后高敏CRP水平、IL-18及IL-10无明显变化,无统计学意义。实验组组治疗1 h、3 h、6 h、12 h后NO水平都不同程度变化,与对照组同时段相比较也有显著升高,差异具有统计学意义(P<0.05);对照组NO水平治疗前、后无明显差异;1年后复查冠脉造影,实验组结果提示术前、后差异无统计学意义,对照组冠脉造影提示管腔狭窄明显,差异有统计学意义。结论冠脉介入治疗可以导致患者机体炎性因子升高,可能有多种因素,但无论何种原因,术后即刻开始使用阿魏酸钠可以有效控制炎性因子的增加,使用阿魏酸钠控制冠脉支架术后患者炎性因子增加的方式值得在心内科推广使用。
Objective To investigate the changes of inflammatory factors in patients with coronary stenting after sodium ferulate, so as to provide reference for clinical cardiologists to carry out postoperative prevention. Methods Sixty patients with acute coronary syndrome who underwent stent implantation were enrolled in this study. The evaluation of admission was completed from March 1, 2014 to March 31, 2015. The patients were randomly divided into treatment group (n = 35) The patients in the control group (n = 25) received routine treatment plus placebo. The patients in both groups were harvested at 6 h before surgery and at 1 h, 3 h, 6 h after operation IL-18 / IL-10 levels were measured in peripheral blood of 12 h, 12 h and 12 h after operation. The levels of NO, hs-CRP, IL-18 and IL- The incidence of coronary restenosis, the experimental results were statistically analyzed. Results There was no significant difference in the levels of hs-CRP, IL-18 and IL-10 between the two groups before operation. The levels of hs-CRP, IL-18 and IL-10 But the difference was not statistically significant. The levels of hs-CRP and IL-18 in the experimental group decreased after treatment for 1 h, 3 h, 6 h and 12 h, and the difference was statistically significant (P <0.05) 10 levels increased within the group also statistically significant differences may be related to the role of sodium ferulate, IL-18 / IL-10 decreased, indicating the role of sodium ferulate treatment significantly, the difference was statistically significant; control There was no significant difference in high-sensitive CRP level between before and after treatment, IL-18 and IL-10. Compared with the control group, the levels of NO in experimental group changed significantly at 1 h, 3 h, 6 h, 12 h after treatment, the difference was statistically significant (P <0.05); the NO level There was no significant difference between the two groups before and after treatment. Coronary angiography was reviewed one year later. The results of the experimental group showed no significant difference before and after treatment. The coronary angiography showed that the stenosis was significant in the control group. The difference was statistically significant. Conclusion Percutaneous coronary intervention may lead to elevated inflammatory cytokines in the patient’s body, which may have many factors. However, for any reason, the use of sodium ferulate immediately after the operation can effectively control the increase of inflammatory factors, and the use of sodium ferulate Control of coronary stenting in patients with inflammatory cytokine increases in the way worthy of promotion in the Department of Cardiology.