摘要
目的研究短期大剂量阿托伐他汀对不稳定型心绞痛（UAP）患者经皮冠状动脉介入（PCI）治疗后炎症反应和心肌损伤的治疗保护作用。方法将我院心内科2012-10～2013-04收治的UAP患者128例为研究对象,按照随机数字法分为两组：大剂量组术前3 d连续给予阿托伐他汀40 mg,小剂量组术前3 d予常规剂量20 mg。于术前及术后8 h、24 h测定肌钙蛋白Ⅰ（c Tn I）、肌酸激酶同工酶（CK-MB）、超敏C反应蛋白（hs-CRP）水平;对比手术前后谷丙转氨酶（ALT）、肌酸激酶（CK）浓度;术后随访1个月了解心脏不良事件（MACE）及药物不良反应发生率。结果 PCI术后,大剂量组c Tn I、CK-MB及HsCRP浓度低于小剂量组（P〈0.05）,大剂量组术后心肌损伤标志物c Tn I、CK-MB升高的发生率低于小剂量组（P〈0.05）;两组患者用药前血脂无明显差异,用药后血脂均有所下降,且术前、术后7 d及术后1个月组间比较差异均无统计学意义（P〉0.05）。随访1个月,两组患者均无心血管不良事件发生。两组药物不良反应发生率无统计学差异（P〉0.05）。结论短期大剂量阿托伐他汀可以减少不稳定型心绞痛患者经皮冠状动脉介入围术期炎症反应和心肌损伤,值得临床推广和应用。
Objective To investigate the effects of short-term high dose of atorvastatin on myocardial injury and inflammatory reaction in PCI patients with unstable angina pectoris （UAP）. Methods A total of 128 patients with UAP hospitalized from October 2012 to April 2013 were randomly divided into 2 groups ： high dose group and low dose group. The patients were given atorvastatin 40 mg for 3 d prior to PCI in high dose group and 20 mg in low dose group. Levels of troponin I （cTnI） , creatine kinase-MB（CK-MB） and high sensitive C-reactive protein （hs-CRP） in the blood from elbow vein were measured at baseline and at 8 h and 24 h after the procedure. Concentrations of creatine kinase（CK） and alanine aminotransferase were observed before and after PCI. The major adverse cardiac e- vent and drug side effect were observed and compared between the two groups. Results After PCI, the levels of cTnI, CK-MB and Hs-CRP were lower in high dose group than in low dose group（ P 〈 0.05 ）. The incidences of the elevated cTnI and CK-MB in low dose group were higher than those in high dose group. The blood lipids were not significantly different between two groups before surgery, at 7 d and at 1 month after surgery（P 〉 0.05）. After treatment, the blood lipids were decreased. After followed-up for 30 d, no major adverse cardiac event occurred. There was no significant difference in the drug side effect between two groups（P 〉 0.05）. Conclu- sion Short-term high dose of atorvastatin is effective for reducing the occurrence of perioperative inflammatory response and myocardial injury of PCI patients with UAP.
出处
《山西医科大学学报》
CAS
2015年第4期293-296,共4页
Journal of Shanxi Medical University
关键词
阿托伐他汀
经皮冠状动脉介入治疗
心肌损伤
炎症反应
atorvastatin
percutaneous coronary intervention
myocardial injury
inflammatory reaction
