急性冠脉综合征中性粒细胞弹性蛋白酶浓度在他仃类药物干预下的变化研究

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[目的]研究他仃类药物对急性冠脉综合征(ACS)血浆患者中性粒细胞弹性蛋白酶(Neutrophil elastaseNE)的影响。[方法]将91名冠心病患者分成4组:(1)急性心肌梗死组(AMI组)45例,(2)不稳定型心绞痛组(UAP组)18例,(3)稳定型心绞痛组(SAP组)13例,(4)陈旧性心肌梗死组(OMI组)15例,AMI组和UAP组合并为ACS组,为冠脉急性病变(A组);SAP组和OMI组合为慢性冠脉病变(B组),两组同时给予氟伐他仃胶囊。患者在入组时、服药后1周、第1月、第12月内抽取静脉血,PMN Elastase Kit试剂盒以酶联免疫吸附检测法(ELISA)检测患者血浆中NE浓度。同时观察患者在12个月内心绞痛发病率和其他心血管事件发生率。[结果](1)A组和B组在入组时所测得的NE浓度的差异有统计学意义(H=34.503,P﹤0.000 1),(2)给予氟伐他汀干预后,发现A组所测得的NE浓度的差异在不同时期比较有统计学意义(χ2=13.537,P﹤0.05);B组所测得的NE浓度的差异在不同时期比较无统计学意义(χ2=2.523,P﹥0.05),(3)A组和B组在应用氟伐他汀治疗1年,心绞痛和其他心血管事件发生率均较低,两组比较差异无统计意义(P﹥0.05)。[结论]血浆NE浓度与急性冠脉综合症有相关性。在氟伐他仃的干预下,血浆NE浓度在急性病程不同时段里变化差异有统计学意义,在慢性病程中变化不大;再次发生心绞痛和其他心血管事件发病率下降,两组差异无统计学意义,进一步证实氟伐他仃可以减少心绞痛和其他心血管事件发病率。 [Objective] To investigate the effects of dutin-type drugs on neutrophil elastase NE in patients with acute coronary syndrome (ACS). [Methods] Ninety-one patients with coronary heart disease were divided into four groups: (1) 45 patients with acute myocardial infarction (AMI), 18 patients with unstable angina (UAP), 3 patients with stable angina SAP group), and (4) 15 elderly patients with AMI (OMI group). AMI group and UAP group were ACS group, which were acute coronary lesions (group A). ​​SAP group and OMI group were chronic coronary artery Lesions (B group), both given fluvastatin capsules. Patients were enrolled in the first week after taking medicine, the first month, the first 12 months of venous blood samples were collected, PMN Elastase Kit kit for enzyme-linked immunosorbent assay (ELISA) detection of plasma concentrations of NE in patients. Simultaneous observation of patients with angina pectoris incidence and other cardiovascular events within 12 months. [Results] (1) There was significant difference in NE concentration between group A and group B (H = 34.503, P <0.0001). (2) After intervention with fluvastatin, A The difference of NE concentration measured by the two groups was statistically significant at different time points (χ2 = 13.537, P <0.05). There was no significant difference in NE concentration measured in group B between different periods (χ2 = 2.523, P> 0.05). (3) The incidence of angina pectoris and other cardiovascular events was lower in group A and group B after 1 year of treatment with fluvastatin. There was no significant difference between the two groups (P> 0.05). [Conclusion] There is a correlation between plasma NE concentration and acute coronary syndrome. In the fluvastatin group intervention, plasma NE concentration in the acute period at different time changes in the difference was statistically significant changes in the course of chronic disease; recurrence of angina pectoris and other cardiovascular events decreased incidence of differences between the two groups without statistics Significance, further confirmed that fluvastatin can reduce the incidence of angina pectoris and other cardiovascular events.
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