术前强化阿托伐他汀治疗对择期PCI术后无复流及r心功能的影响

摘要

目的:探讨术前强化阿托伐他汀治疗对择期经皮冠状动脉介入(PCI)术后无复流现象及心功能的影响.方法:选择我院2015年2月~2016年2月收治的96例择期PCI术患者.按照完全随机化分组法,患者被随机均分为正常剂量组(接受常规剂量阿托伐他汀治疗)和强化组(接受强化阿托伐他汀治疗).观察比较两组术前,术后1个月校正TIMI帧数(CTFC)、左心室射血分数(LVEF)、左室收缩末容积指数(LVESVI)、左室舒张末容积指数(LVEDVI)以及无复流发生率.结果:与正常剂量组比较,PCI术后1个月强化组右冠脉[(36.96±5.48)比(29.87±6.03)]、左前降支[(37.57±6.31)比(30.25±5.74)]、左回旋支[(37.01±6.04)比(26.52±5.73)]CTFC以及平均CTFC[(37.03±6.21)比(29.24±6.02)]、无复流发生率(16.67%比4.17%)、LVES-VI[(37.23±10.49)ml/m2比(30.46±11.53)ml/m2]和LVEDVI[(80.02±14.38)ml/m2比(71.34±16.52)ml/m2]显著降低,LVEF[(43.11±5.23)%比(47.37±7.57)%]显著升高,P<0.05或<0.01.结论:术前强化阿托伐他汀治疗可有效降低PCI术后无复流发生率,改善患者心功能,值得推广.%Objective:To explore influence of preoperative intensive atorvastatin therapy on no-reflow and cardiac function after selective percutaneous coronary intervention (PCI).Methods:A total of 96 selective PCI patients treated in our hospital from Feb 2015 to Feb 2016 were selected.According to complete random grouping method, patients were randomly and equally divided into normal dose group (received atorvastatin of normal dose)and inten-sive group (received intensive atorvastatin therapy).Corrected TIMI frame count (CTFC),left ventricular ejection fraction (LVEF),left ventricular end-systolic volume index (LVESVI),left ventricular end-diastolic volume index (LVEDVI)before and one month after PCI,incidence rate of no-reflow were observed and compared between two groups.Results:Compared with normal dose group on one month after PCI,there were significant reductions in CTFCs of right coronary artery [(36.96±5.48)vs.(29.87±6.03)],left anterior descending artery [(37.57± 6.31)vs.(30.25±5.74)],left circumflex artery [(37.01±6.04)vs.(26.52±5.73)],mean CTFC [(37.03± 6.21)vs.(29.24±6.02)],incidence rate of no-reflow (16.67% vs.4.17%),LVESVI [(37.23±10.49)ml/m2 vs.(30.46±11.53)ml/m2 ]and LVEDVI [(80.02±14.38)ml/m2 vs.(71.34±16.52)ml/m2 ],and significant rise in LVEF [(43.11±5.23)% vs.(47.37±7.57)%]in intensive group,P <0.05 or <0.01. Conclusion:Preop-erative intensive atorvastatin therapy can effectively reduce incidence rate of no reflow and improve cardiac function of patients after PCI,which is worth extending.