摘要
目的观察大剂量阿托伐他汀对急性心肌梗死(AMI)患者冠状动脉介入治疗(PCI)术后内皮素-1(ET-1)、一氧化氮(NO)、可溶性细胞间黏附分子-1(slCAM-1)及高敏C-反应蛋白(hs-CRP)、血脂的影响。方法选择2012年9月—2014年9月确诊为AMI并成功行PCI术的患者113例,按数字表法随机分为对照组58例、治疗组55例,2组患者均常规抗凝、抗血小板,逆转心室重构药物,对照组在常规治疗基础上加用阿托伐他汀20 mg口服,治疗组患者在常规治疗基础上加用阿托伐他汀40 mg口服。2组患者均于入院即刻、术后1、30 d时测定外周血NO、ET-1、slCAM-1、hs-CRP水平及血脂水平。观察不同剂量阿托伐他汀对于炎性指标、内皮功能及血脂的影响。结果与治疗前比较,2组治疗30 d ET-1、slCAM-1、hs-CRP及血脂水平降低(P<0.05),NO水平升高(P<0.05)。且治疗30 d时,治疗组较对照组比较变化更为显著(P<0.05)。2组不良反应比较差异无统计学意义(P>0.05)。结论阿托伐他汀可以降低AMI患者PCI术再灌注后炎性反应,改善血管内皮功能,大剂量的阿托伐他汀较常规剂量效应强,且无明显不良反应。
Objective To observe the effects of high dose atorvastatin on enodthelin-1 （ ET-1） , nitric oxide （ NO） , soluble intercellular adhesion molecule 1 （slCAM-1） and high sensitive C reactive protein （hs-CRP）, blood lipid in acute myocardial infarction （ AMI ） patients with percutnaeous coronary intervention （ PCI ） .Methods From September 2012 to September 2014, 113 patients with AMI after PCI were randomly divided into control group （58 cases） and treatment group （55 cases） , 2 groups were treated with routine anticoagulation, antiplatelet, reverse ventricular remodeling drugs, control group based on the conventional therapy added atorvastatin 20 mg orally, the patients in the treatment group were treated with atorvastatin 40 mg orally on the basis of conventional therapy.2 groups of patients at the immediate and after 1, 30 d admis-sion, peripheral blood NO, ET-1, slCAM-1, hs-CRP level and blood lipid level were determined.Observed the effect of dif-ferent doses of atorvastatin on inflammatory markers, endothelial function and blood lipid.Results Compared with before treatment, after 30 d’ s treatment, ET-1, slCAM-1, hs-CRP and lipid levels were decreased in both of the 2 groups （ P〈0.05）, level of NO were elevated.And at 30 d’s treatment, these indices in the treatment group were more significant than the control group （ P〈0.05）.No statistically significant differences of adverse reactions were found in the 2 groups （ P〉0.05）.Conclusion Atorvastatin can decrease the inflammatory reaction of reperfusion after PCI in AMI patients, improve endothelial function, high dose of atorvastatin has more obvious effect than the conventional dose and no obvious adverse reac-tion were found.
出处
《疑难病杂志》
CAS
2015年第5期445-448,共4页
Chinese Journal of Difficult and Complicated Cases
基金
河南省教育厅科技重点项目(No.14A320051)
河南省高校科技创新团队(No.13IRTSTHN012)
郑州市科技创新团队项目(No.121PCXTD520)
关键词
心肌梗死
急性
冠状动脉介入
内皮功能
阿托伐他汀
Myocardial infarction,acute
Percutaneous coronary intervention
Endothelial function
Atorvastatin
