负荷剂量阿托伐他汀对急性冠状动脉综合征患者经皮冠状动脉介入治疗围术期的影响

摘要

目的:探讨负荷剂量阿托伐他汀对急性冠状动脉综合征(acute coronary syndrome,ACS)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)围术期的影响.方法:将2014年7月-2015年12月收治的120例ACS患者按随机数字表法分为观察组和对照组,每组60例.两组患者均在PCI术前、术后给予常规治疗,观察组患者在上述基础上,于PCI术前口服阿托伐他汀负荷剂量80 mg,术后口服阿托伐他汀40 mg.比较两组患者PCI术前及术后8、24 h血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)和超敏C反应蛋白(hs-CRP)水平,并记录主要心脏不良事件(major adverse cardiac events,MACE)发生情况.结果:PCI术后,两组患者的CK-MB、cTnI、hs-CRP水平均明显升高,但观察组患者各指标升高程度明显低于对照组,差异均有统计学意义(P<0.05).对照组患者MACE发生率为13.33%(8/60),明显高于观察组的5.00%(3/60),差异有统计学意义(P<0.05).MACE中,非致死性心肌梗死多见.结论:阿托伐他汀能够减轻PCI相关心肌损伤,改善患者预后,降低MACE的发生概率.%OBJECTIVE:To probe into the effects of loading dose atorvastatin on acute coronary syndromes (ACS) during perioperative period.METHODS: 120 patients with ACS admitted from Jul.2014 to Dec.2015 were selected to be divided into observation group and control group via the random number table, with 60 cases in each.Two groups were given conventional treatment before and after percutaneous coronary intervention (PCI), based on which, the observation group received dose of 80 mg atorvastatin before PCI and 40 mg after PCI orally.The creatine kinase isoenzymes (CK-MB), cardiac troponin I (cTnI), and high sensitive C-reactive protein (hs-CRP) levels of two groups were compared before and after PCI of 8 hours, 24 hours, and the incidence of major adverse cardiac events(MACE)were recorded.RESULTS: After PCI, the CK-MB, cTnI and hs-CRP levels of two groups increased significantly, yet the increasing range of various indicators of observation group was lower than those of control group, with statistically significant difference(P<0.05).The incidence of MACE in control group was 13.33%(8/60), significantly higher than that of observation group [5.00%(3/60)], with statistically significant difference(P<0.05).Of the MACE cases, nonfatal myocardial infarction was common.CONCLUSIONS: Atorvastatin can reduce PCI-related myocardial injury, improve the prognosis of patients and reduce the incidence of MACE.