强化瑞舒伐他汀对急性冠脉综合征介入治疗患者的临床疗效影响

Effect of Intensive Rosuvastatin on Acute Coronary Syndrome Patients Treated with PCI

【目的】探讨强化瑞舒伐他汀治疗对经皮冠状动脉介入治疗术（PCI）的非ST段抬高型急性冠脉综合征（NSTEACS）患者的影响及可能机制。【方法】择期PCI的NsTEACS患者384例，随机分为标准瑞舒他汀组（n=191）和强化瑞舒伐他汀组（n=193），于PCI前、术后24h测量高敏C反应蛋白（hs—CRP）、肌钙蛋白I（cTnI）、肌酸磷酸激酶（CK—MB）水平；于PCI前、术后3d测量血肌酐（SCr）水平；记录30d、180d内主心血管事件（MACE）和严重不良反应的发生。【结果】两组PCI术后24h的CK—MB、cTnI、hs—CRP均有升高，强化组低于标准组（P〈0．05）；强化组术后180d内MACE显著低于标准组（P〈0．05）；两组间SCr及不良事件无明显差异（P〉0．05）。【结论】使用强化瑞舒伐他汀治疗比标准瑞舒伐他汀治疗能显著降低hs—CRP水平，减少围手术期心肌梗死及术后180d内MACE发生率，且不增加不良事件。

[Objective] To explore the effect of intensive rosuvastatin treatment on non-ST segment elevation a- cute coronary syndrome（NSTEACS） patients treated with percutaneous coronary intervention（PCI） and its possible mechanism. [Methods] A total of 384 NSTEACS patients scheduled for PCI were randomly divided into standard ro- suvastatin group（ n = 191） and intensive rosuvastatin group（ n = 193）. The levels of high sensitive C-reactive protein （hs-CRP）, troponin I（cTnI） and CK-MB were measured before and 24 hours after PCI. Serum creatinine（Ser） was measured before and 3 days after PCI. The incidence of major adverse cardiac event（MACE） and serious adverse drug reaction were recorded within 30 days and 180 days. [Results] The levels of CK-MB, cTnI and hs-CRP in two groups 24h after PCI were increased, and those in intensive group were lower than those in standard group（ P 〈0.05）. The MACE in intensive group within 180 days after PCI was significantly lower that in standard group（ P 〈0.05）. There was no obvious difference in Scr and the incidence of adverse events between two groups（ P 〉0.05）. [Conclusion] Compared with standard rosuvastatin treatment, intensive rosuvastatin treatment can significantly reduce the level of hs-CRP, decrease the incidence of myocardial infarction and MACE within 180 days after operation and not increase the incidence of adverse events.