长期应用阿托伐他汀钙对再次冠脉介入治疗患者的影响

Effect of long-term pretreatment with atrvastatin on patients undergoing the second percutaneous coronary intervention

目的:评价连续≥6个月应用阿托伐他汀钙对再次冠状动脉介入治疗(PCI)患者CD40L水平变化及心肌损伤的影响。方法:入选因不稳定心绞痛行第二次PCI治疗患者90例,在再次PCI术前已连续口服阿托伐他汀钙≥6个月的患者作为观察组,术前因各种原因未服用阿托伐他汀钙及其他降脂药物的患者作为对照组,所有入选者于再次PCI术前,PCI术后12、24、48h检测肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)以及血清CD40L水平。结果:PCI术前,CD40L水平在观察组较低。观察组PCI术后12、24h,CK-MB水平较对照组明显降低(P<0.05);cTnI在PCI术后12、24、48h3个时间段均明显低于对照组(P<0.05)。CD40L术后24h明显低于对照组(P<0.05)。与术前相比,对照组CK-MB在术后各时段上升明显(P<0.05),CD40L在术后12、24h均显著增高。结论:长期应用阿托伐他汀钙可减轻冠状动脉介入治疗对心肌的损伤,使可溶性CD40L增幅下降。

Objective To investigate the potential effects of taking atrvastain more than 6 months on CD40L expression and myocardial damage of patients undergoing percutaneous coronary intervention （PCI） once again. Methods A total of 90 patients with unstable angina were randomized into groups of pretreatment with continuous atrvastatin （6 months before the second PCI, atrvastatin group） and without atrvastatin （control group）. Creatine kinase-MB （CK-MB）, tropoinin I （cTnI）, and CD40L level were determined at 12, 24 and 48 hours post the second PCI. Results Before PCI, low level of CD40L was observed in the atrvastatin group. CK-MB level was significantly reduced in the atrvastatin group ＇ （P 〈 0.05） 12 and 24 hours after PCI, cTnIs were significantly decreased in the atrvastatin group （P 〈 0.05）12, 24 and 48 hours after PCI; CD40 L was significantly reduced in the atrvastatin group （P 〈 0.05） 24 hours after the PCI. In the control group, the CK-MB upgraded obviously（P 〈 0.05）, and CD40 expression was markedly upregulated at 12 and 24 hours after the operation. Conclusion Longterm pretreatment with atrvastatin may alleviate myocardial damage of patients undergoing PCI and. decrease soluble CD40L amplification.