大剂量阿托伐他汀强化治疗对支架术后再狭窄的影响

Effect of intensive treatment with high-dose atorvastatin on in-stent restenosis after coronary stenting

目的探讨大剂量阿托伐他汀强化治疗对急性冠脉综合征(ACS)患者支架术后再狭窄(ISR)的预防作用,同时观察其血脂达标率。方法共102例ACS患者分为两组,观察组在术后48h内开始给予阿托伐他汀40mg,对照组10mg,每晚顿服。护士定期电话随访,于4周、12周、24周复查血脂、肝功,24周时复查冠脉造影。结果观察组术后TC、LDL-C逐渐下降,与对照组相比差异有统计学意义(P<0.01)。24周时观察组LDL-C达标率为46.1%,优于对照组的24%(P<0.05)。观察组有43例行冠脉造影,5例再狭窄,对照组40例行冠脉造影,12例再狭窄,观察组再狭窄率明显低于对照组(P<0.05)。用药期间,监测肝酶情况,24周时未出现超过正常上限3倍病例。结论大剂量阿托伐他汀强化治疗可降低支架内再狭窄的发生率,增加血脂的达标率,强化降脂是安全有效的。

Objective To assess the role of high-dose atorvastatin in patients with acute coronary syndrome（ACS） for controlling in-stent restenosis（ISR）,and to observe the levels of lipid.Methods A total of 102 patients with ACS were divided into the study group（n=52） and the control group（n=50）.Patients in the study group were tghive ep 4a0ti㎎entast owrvearest afotilnlo wwiethdi nu p4 8p ehroioudrsi caafltleyr,saunrdg ehrayd,wthhei leli pthidast iann dth etr acnosnatmroiln garsoeu dpe wteecrtee dg i4v,e 1n2 1,02 4㎎ w aeteokrvs aasfttaetrin t.r eAatl-l ment.The coronary angiography were checked at 24 weeks post-treatment.Results The levels of TC and LDL-C in both the groups showed a gradual downward trend,but the decline in the study group is more pronounced（P0.01）.The standard-reaching rate of LDL-C in the study group at 24 weeks post-treatment was 46.1%,which was significantly higner than that in the control group（P〈0.05）.In the study group,43 patients underwent coronary angiography and 5 were diagnosed as ISR,while in the control group 40 patients received coronary angiography and 12 were diagnosed as ISR.No case were found with more than three times of the upper limit of transaminase.Conclusion Intensive therapy with high-dose atorvastatin can significantly reduce the incidence of ISR and increase the standard-reaching rate of lipids.