阿托伐他汀治疗支架植入术后高原冠心病患者的临床观察

Safety and efficacy of atorvastatin in treatment of patients with coronary artery disease at high altitude after drug-eluting stent implantation

目的观察高剂量阿托伐他汀治疗高原冠心病(CAD)患者行冠状动脉支架植入术后的疗效及安全性。方法将75例在高原世居的CAD患者按就诊顺序以1∶1的比例分为阿托伐他汀低剂量组(n=37)和高剂量组(n=38),两组患者分别接受每晚20 mg和40 mg的阿托伐他汀口服治疗,其余基础治疗相同。观察1年内心血管事件、支架内再狭窄、肌酶异常和横纹肌溶解的发生率。结果低剂量组1年内心血管事件的发生率为21.6%,高剂量组为5.3%,两组间有显著差异(χ2=4.34,P<0.05);低剂量组1年时支架内再狭窄的发生率为18.9%,高剂量组为2.6%,两组间有显著差异(χ2=5.22,P<0.05);两组患者均未观察到肌酶升高和横纹肌溶解。结论高剂量阿托伐他汀可降低高原CAD患者行冠状动脉支架植入术后心血管事件和再狭窄的发生率,且不增加肌酶异常和横纹肌溶解的发生率。

Objective To observe the curative effect and safety of high-dose atorvastatin in the treatment of patients with coronary artery disease（CAD）after drug-eluting stent implantation.Methods 75 high-altitude habitants with CAD receiving the implantation of at least one drug-eluting stents were divided into low-dose atorvastatin group（n=37,20 mg quaque nocte）and high-dose atorvastatin group（n=38,40 mg quaque nocte）.The basic therapy was similar between the two groups.The incidence of cardiovascular events,in-stent restenosis,creatase abnormalities and rhabdomyolysis within one year were recorded.Results The incidence of cardiovascular events in the low-dose group was significantly higher than that in the high-dose group（21.6% vs.5.3%,P〈0.05）.The incidence of in-stent restenosis in the low-dose group was significantly higher than that in the high-dose group（18.9% vs.2.6%,P〈0.05）.The creatase abnormalities and rhabdomyolysis were not found.Conclusion Usinghigh-dose atorvastatin in patients at high altitude with CAD can significantly decrease cardiovascular events and in-stent restenosis within one year without the increase of creatase abnormalities and rhabdomyolysis.