不同剂量瑞舒伐他汀对冠心病患者Rho激酶活性和内皮功能影响的比较
| 作者: |
1楚轶,
1程锦,
1卢少平
1 第四军医大学附属唐都医院心血管内科，西安 710038 |
| 通讯: |
楚轶
Email: ada5256@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2016.09.014 |
摘要
目的：研究不同剂量瑞舒伐他汀对冠心病患者Rho激酶活性和内皮功能影响。方法：选取2014年6月至2015年11月我院接收的稳定型心绞痛患者128例，按照随机数字表法将其分为对照组、实验A、实验B、实验C四组，每组各32例。对照组参照临床用药指南，根据患者病情给予硝酸酯类、抗血小板凝集、抗凝、降血糖、控制血压等常规治疗，实验A、B、C三组患者在常规治疗的基础上分别予以口服5、10、20 mg不同剂量的瑞舒伐他汀，频率均为每天1次，持续时间为8周。检测并比较4组患者治疗前后的超敏C反应蛋白(hs-CRP)、Rho激酶(Rho kinase，ROCK)活性、肱动脉内皮依赖性舒张功能(flow-mediated dilatation，FMD)、总胆固醇(TC)的差异以及各组患者出现的不良反应情况。结果：治疗前，对照组以及实验A、B、C组患者的指标检测无明显差异，无统计学意义(P>0.05)。治疗后，对照组的hs-CRP含量为(3.13±0.67) mg/L，实验A、B、C组分别为(2.67±0.73)、(2.15±0.44)、(1.87±0.32) mg/L，均与对照组差异明显(P<0.05)，且hs-CRP含量随瑞舒伐他汀剂量增大而降低；对照组Rho激酶(ROCK)活性为(62.73±12.67)%，实验A、B、C组分别为(53.71±10.98)%、(41.63±9.61)%、(35.46±9.24)%，均明显低于对照组(P<0.05)，且随瑞舒伐他汀剂量增大，ROCK活性越来越弱；对照组FMD水平为(4.27±1.63)%，实验A、B、C组分别为(6.62±1.51)%、(8.15±1.32)%、(9.97±1.38)%，均明显高于对照组(P<0.05)，且瑞舒伐他汀剂量越大，FMD水平越高；对照组TC含量为(5.76±0.73) mmol/L，实验A、B、C组分别为(5.01±0.73)、(4.92±0.62)、(4.21±0.58) mmol/L，均明显低于对照组(P<0.05)，且随瑞舒伐他汀剂量增大，TC含量越来越低；不良反应情况：实验A组患者血清转氨酶超标、横纹肌溶解以及肌肉酸痛出现次数分别为1、2、1例，B组为1、3、2例，C组为2、2、1例，结果对比无统计学差异(P>0.05)。结论：对于冠心病患者而言，瑞舒伐他汀能够抑制Rho激酶活性，缓解患者内皮功能紊乱状况，明显改善血管内皮功能，并存在量效关系，且使用高剂量的瑞舒伐他汀是安全的。
关键词：
瑞舒伐他汀
冠心病患者
Rho激酶活性
内皮功能
Effect of different doses of rosuvastatin on Rho kinase activity and endothelial function in patients with coronary heart disease
CorrespondingAuthor: CHU Yi Email: ada5256@163.com
DOI: 10.3978/j.issn.2095-6959.2016.09.014
Abstract
Objective: To explore the effect of different doses of rosuvastatin on Rho kinase activity and endothelial function of patients with coronary heart disease. Methods: 128 patients with stable coronary heart disease were selected in our hospital from June 2014 to November 2015, and divided into four groups (control group, experimental group A, B, C) according to the random number table, 32 patients in each group. According to the clinical medication guide, patients in control group were treated by giving nitrates, anti-platelet aggregation, anticoagulation, lowering blood sugar, controlling blood pressure and other conventional treatment according to the patient’s condition, patients in experimental group A, B, C were treated by different doses of 5, 10, 20 mg rosuvastatin on the basis of conventional treatment, the frequency of medication was once a day, the time of comparative treatment was lasting for 8 weeks. The level of hypersensitive C reactive protein (hs CRP), Rho kinase (rock) activity, endothelium-dependent vasodilator function of the brachial artery, total cholesterol (TC) and adverse reaction of four groups were detected and compared. Results: Before the treatment, the index levels of four groups have no significant difference (P>0.05). After treatment, the hs-CRP level in control group was (3.13±0.67) mg/L, and experimental group A, B, C were respectively (2.67±0.73), (2.15±0.44), (1.87±0.32 ) mg/L, the hs-CRP level in experimental group A, B, C were all significantly lower than control group (P<0.05), and the level of hs-CRP reduced as the dose of rosuvastatin increasing; the Rho kinase (ROCK) activity in control group was (62.73±12.67)%, the Rho kinase (ROCK) activity in experimental group A, B, C were respectively (53.71±10.98)%, (41.63±9.61)%, (35.46±9.24)%, the Rho kinase (ROCK) activity in experimental group A, B, C were all significantly lower than those in control group (P<0.05), and the ROCK activity was lower as the dose of rosuvastatin increasing; the level of FMD of control group was (4.27±1.63)%, the level of FMD in experimental group A, B, C were respectively (6.62±1.51)%, (8.15±1.32)%, (9.97±1.38)%, the level of FMD in experimental group A, B, C were all significantly higher than the control group (P>0.05). And the level of FMD was higher as the dose of rosuvastatin increasing; the level of TC in control group was (5.76±0.73) mmol/L, the level of TC in experimental group A, B, C group were respectively (5.01±0.73), (4.92±0.62), (4.21±0.58) mmol/L, the level of TC in experimental group A, B, C were all significantly lower than control group (P<0.05), and the level of TC was lower as the dose of rosuvastatin increasing; Adverse reaction conditions: Excessive levels of serum aminotransferase rhabdomyolysis and muscle aches in experimental group A were respectively 1, 2, 1 cases, experimental group B were respectively 1, 3, 2; experimental group C were respectively 2, 2, 1 cases, there was no statistically significant (P>0.05). Conclusion: For the patients with coronary heart disease, rosuvastatin can inhibit the activity of Rho kinase, relieve the disorders of endothelial function and significantly improve the endothelial function, there is a dose-response relationship, and high doses of rosuvastatin simvastatin are safe.