不同剂量辛伐他汀对老年冠状动脉介入术后血小板活化的影响

The different-dose simvastatin's effect on the platelet activity after the elderly patients' treatment by PCI

目的评价不同剂量辛伐他汀对急性冠状动脉综合征(ACS)冠脉介入术后患者血小板膜糖蛋白CD62p、CD63的影响。方法选择在深圳市人民医院2002—2006年住院的ACS患者68例并随机分为辛伐他汀20mg/d组(36例)和辛伐他汀40mg/d组(32例),全部患者于冠脉介入术前进行血小板CD62p、CD63测定,并分别给予辛伐他汀20mg/d和辛伐他汀40mg/d睡前口服,4周后两组均复查CD62p、CD63,并进行治疗前后比较及两组间的比较。结果辛伐他汀20mg/d组和40mg/d组治疗4周后,与治疗前比较CD62p、CD63明显下降,各组内治疗前后比较P均<0.01。治疗后40mg/d组与20mg/d组比较,CD62p下降更显著,差异有显著性意义(P<0.05);治疗后两组CD63差异无显著性意义(P>0.05)。结论辛伐他汀20mg/d和40mg/d均具有抑制血小板活化的作用,辛伐他汀40mg/d效果更好,在预防和治疗血栓性疾病中有一定的临床价值,临床上可用于冠脉介入术后预防和治疗冠脉内的血栓形成。

Objective To observe the serum level of the CD62p, CD63 which indicates the platelet activity of the elderly patients treated by different-dose simvastatin after PCI. Methods Sixty - eight patients with acute coronary syndrome post PCI were randomly divided into 20 mg/d simvastatin group （ 36 patients ） and 40 mg/d simvastatin group （ 32 patients）. We examined the patient＇s blood CD62p, CD63 levels on the day before the treatment of PCI in both groups. Then all of the patients in both groups received different-dose simvastatin treatment（20mg/d or 40 mg/d qn po） ;we observed the results again after four weeks in both groups, and compared the results. Results The patients＇ blood CD62p, CD63 levels decreased significantly after the treatment of simvastatin in both groups（ P 〈 0. 01 ）. The CD62p level in 40 mg/d group decreased significantly after the treatment compared with that in 20 mg/d group （P 〈 0. 05）. Conclusion Simvastatin can inhibit the patients＇ platelet activity after the treatment by PCI. The effect of treatment is better in 40 mg/d simvastatin group than 20 mg/d simvastatin group.