大剂量阿托伐他汀对PCI术后心肌损伤及预后的影响

摘要

Objective To discuss the influence of high—dose atorvastatin administration on myocardium in perioperative period of percutaneous coronary intervention ( PCI ) . Methods The patients ( n=19 ) with unstable angina pectoris ( UAP ) were randomly divided into control group ( n=39 ) and treatment group ( n=40 ) . The control group was given routine anti—myocardial ischemia, anticoagulative and antithrombotic therapies before PCI, and treatment group was additionally given oral atorvastatin ( 80 mg ) 12 hours before PCI. After PCI the two groups were given routine-dose atorvastatin ( 20 mg ) orally once a day. The changes of cardiac troponin I ( cTnl ) , creatine kinase MB ( CK—MB ) and C—reactive protein ( CRP ) before and after PCI, and incidence of major adverse cardiovascular events ( MACE ) and adverse reactions within 30 days after PCI were observed in two groups. Results The increase degree of cTnl, CK—MB and CRP was significantly lower in treatment group than that in control group with statistical difference ( P<0.05 ) . The incidence of MACE was lower in treatment group than that in control group with statistical difference ( P<0.05 ) . Conclusion The administration of high-dose atorvastatin in the patients with UAP before PCI can ameliorate clinical prognosis and alleviate myocardial injury.%目的 探讨大剂量阿托伐他汀钙对在经皮冠状动脉介入治疗(PCI)围手术期的应用对心肌损伤及预后的影响.方法 将79例不稳定型心绞痛(UAP)患者随机分为对照组(n=39)和治疗组(n=40),对照组PCI术前予常规改善心肌缺血、抗凝、抗栓治疗.治疗组在对照组基础上于PCI术前12小时加服阿托伐他汀80mg,术后两组均给予常规剂量的阿托伐他汀20mg,每天一次口服.观察两组PCI术前后心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)和C-反应蛋白(CRP)的变化及术后30天内主要心血管事件及不良反应发生率.结果 治疗组血清cTnI、CK-MB和CRP升高程度明显低于对照组,两组比较有统计学差异(P＜0.05);治疗组心血管事件发生率低于对照组,两组比较有统计学差异(P＜0.05).结论 UAP患者PCI术前应用高剂量阿托伐他汀钙可改善患者临床预后,减轻心肌损伤.