改良他汀序贯治疗对PCI术后斑块稳定性的影响

Effects of Modified Sequential Therapy Regimen with Atorvastatin on Postoperative Stability of Coronary Atherosclerotic Plaque after Percutaneous Coronary Intervention

目的评价改良的阿托伐他汀序贯治疗对经皮冠状动脉介入治疗(PCI)术患者血清高敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)及其内皮功能的影响。方法选取PCI患者100例随机分组:A组,PCI术前起始负荷量阿托伐他汀80 mg,后40 mg×7 d,以后20 mg qd;B组,PCI术前术后均每日阿托伐他汀20 mg。分别于服药前及术后24 h,服药后7 d分别测定hs-CRP、MMP-9及NO水平。同时观察药物不良反应及血管事件。结果服药前两组患者hs-CRP、MMP-9、NO水平比较差异无统计学意义,术后24 h,hs-CRP、MMP-9较术前升高,NO较术前降低(自身对比,P<0.05,组间对比,P>0.05);服药7 d后两组hs CRP及MMP-9均较术后24 h下降,NO较术后24 h升高(自身对比,P<0.05,组间对比,P<0.05)。结论改良阿托伐他汀序贯治疗可显著降低PCI术后体内炎症反应,稳定斑块,并改善内皮功能,并不增加肌溶解等不良事件发生。

Objective To assess the effects of modified sequential therapy regimen with atorvastatin on the serum hypersensitive C-reactive protein（hs-CRP）,matrix metalloprotease-9（MMP-9） and endothelium function after percutaneous coronary intervention（PCI） in patients with coronary heart disease（CHD）.Methods A total of 100 patients with CHD were randomly divided into two groups.In group A,80 mg of atorvastatin was given once time before PCI,and after PCI,40 mg/d×7 d,then 20 mg qd;in group B,20 mg/d of atorvastatin was given.Blood were taken at baseline,24 h and 7 day after PCI for serum hs-CRP,MMP-9 and NO tests.The major adverse cardiac events and drug side effect were observed.Results There was no significant difference in the level of serum hs-CRP,MMP-9 and NO at base（P0.05）;24 hours after PCI,the level of hs-CRP and MMP-9 increased,while NO decreased（P0.05）;7 d after taking atorvastatin,the level of hs-CRP and MMP-9 decreased while NO increased as compared to the value at 24 h after PCI（P0.05）.Conclusion The modified sequential therapy regimen with atorvastatin can significantly reduce the inflammatory response in vivo after PCI,increase plaque stability,improve endothelial function and does not increase adverse events such as muscle dissolved.