摘要
目的:探讨负荷剂量阿托伐他汀与瑞舒伐他汀对不稳定心绞痛患者PCI围手术期炎性因子的影响。方法:入选我院住院不稳定型心绞痛患者48例,随机分为阿托伐他汀组(24例,术前2d给予阿托伐他汀80mg/d,术后给予40mg/d)和瑞舒伐他汀组(24例,术前2d给予瑞舒伐他汀20mg/d,术后给予10mg/d)。分别于PCI术前及术后18～24h检测心肌损伤标志物心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)以及超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、血清干扰素-γ(IFN-γ)、白细胞介素-10(IL-10)等炎性因子的表达。结果:①PCI术后18～24h,阿托伐他汀组cTnI高于正常高值的发生率低于瑞舒伐他汀组(P<0.05),CK-MB两组间差异无统计学意义;②PCI术后18～24h,两组hs-CRP、TNF-α及IFN-γ均较术前进一步升高,但仅hs-CRP在两组间的差异有统计学意义(P<0.05);③术后两组IL-10均较术前升高,阿托伐他汀组升高较瑞舒伐他汀组明显(P<0.05)。结论:PCI术前给予80mg的阿托伐他汀比给予20mg的瑞舒伐他汀可更有效地降低炎性因子hs-CRP的水平及术后心肌损伤的发生率。
Objective：To investigate the effects of loading-dose atorvastatin and rosuvastatin on inflammatory cytokines during perioperative period of PCI in patients with unstable angina. Method：A total of 48 patients with unstable angina was randomized into atorvastatin group （n=24, 80 mg/d two days before PCI and 40 mg/d after PCI） and rosuvastatin group （n=24, 20 mg/d two days before PCI and 10 mg/d after PCI）. cTnI, CK-MB, hs-CRP, TNF-α, IFN-γ and IL-10 were measured respectively at preoperative and postoperative 18~24 h of PCI. Result：①Compared with rosuvastatin group, the incidence of cTnI elevating above normal level in atorvastatin group was reduced after PCI （P〈0.05）, while the level of CK-MB was not statistically different between two groups after PCI. ②The serum levels of hs-CRP, TNF-α and IFN-γ were increased in both groups after PCI, but the level of hs-CRP in rosuvastatin group was higher than that in atorvastatin group （P〈0.05）. ③The serum level of IL-10 was increased in both groups after PCI, but it was higher in atorvastatin group than that in rosuvastatin group （P〈0.05）. Conclusion：Loading-dose atorvastatin （80 mg） pretreatment can reduced post-PCI myocardial inflammation and periprocedural myocardial injury, which is more effectively than pretreatment of rosuvastatin （20 mg）.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2013年第6期420-422,共3页
Journal of Clinical Cardiology
基金
国家自然科学基金资助项目(No：811(50046)
