围手术期强化阿托伐他汀治疗对冠心病介入治疗所致心肌损伤的保护作用

摘要

目的:探讨强化阿托伐他汀治疗对经皮冠状动脉介入治疗术(percutaneous coronary intervention,PCI)围手术期心肌损伤的即刻保护作用.方法:选择本院择期行PCI术的冠心病(coronary artery disease,CAD)患者60例,随机分为常规治疗组28例,强化他汀治疗组32例.在术前、术后24 h分别测定肌酸激酶MB (creatine kinase-MB,CK-MB)、肌钙蛋白T(cTroponinT,cTnT).结果:常规及强化他汀治疗组中,PCI术后24 h CK-MB＞3倍正常参考值上限(3UNL) (14.3％ vs 9.4％,OR:0.62,95％CI:0.13～3.05,P=0.695)及CK-MB＞1 UNL(21.4％ vs 9.4％,OR:0.38,95％CI:0.09～1.69,P=0.281)的发生率比较无统计学意义,cTnT＞3 UNL(7.1％ vs 6.3％,OR:0.88,95％CI:0.11～6.59,P=1.000)及cTnT＞1 UNL的发生率(14.3％ vs 12.5％,OR:0.86,95％ CI:0.19～3.80,P=1.000)无统计学差异.结论:PCI围手术期给予阿托伐他汀强化治疗没有降低围手术期心肌坏死及梗死的发生率.%Objective: To study the immediate protective effect of intensive atorvastatin treatment on coronary artery disease (CAD) patients in the perioperative period of percutaneous coronary intervention (PCI). Methods:Sixty CAD patients were random ly divided into two groups. The levels of creating kinase MB (CK-MB), cTroponin T (cTnT) were measured before and 24 h after PCI. Results: The frequencies of CK-MB > 3 UNL (14.3% vs 9.4%) and CK-MB > 1 UNL (21.4% vs 9.4%) was insignificant in the con ventional treatment and intensive atorvastatin treatment groups at 24 h after PCI(CK-MB > 3 UNL,OR:0.62,95%CI:0.13~3.05,P = 0.695;CK-MB > 1 UNL,OR:0.38,95%CI:0.09-1.69,P = 0.281). In the two groups,the occurrences of cTnT > 3 UNL (7.1% vs 6.3%) and cTnT > 1 UNL (14.3% vs 12.5%) were not remarkable at 24 h after PCI (cTnT > 3 UNL, OR:0.62,95%CI: 0.13~ 3.05,P = 0.695;cTnT > 1 UNL,OR:0.86,95%CI:0.19~3.80,P = 1.000). Conclusion: For the CAD patients,the enhanced atorvas tatins in the perioperative period of PCI would not further reduce the rates of myocardial necrosis and infarction.