瑞舒伐他汀对晚期支架贴壁不良的影响

The effect of rosuvastatin on late stent malapposition

目的研究瑞舒伐他汀与晚期支架贴壁不良的相关性。方法选取63例患者，将其分为治疗组和对照组，其中治疗组35例，支架置人术前后持续口服瑞舒伐他汀10mg，1次／d，至复查造影时；对照组28例，支架置人术前后不服或服用瑞舒伐他汀10mg，1次／d，总时间少于4周。两组患者支架置人后即刻行血管内超声检查（IVUS），且在支架置人后6-9个月复查IVUS和冠状动脉造影。两次住院期间均检测血清高敏C-反应蛋白（hs—CRP）和低密度脂蛋白胆固醇（LDL—C）。结果治疗组有3例患者发生晚期支架贴壁不良，共计4个部位；对照组为8例，共13个部位；两组差异有统计学意义（P〈0．05）。治疗组血管外弹力膜增加面积、中膜增加面积、管腔减少面积、内膜增生横截面积均小于对照组．差异有统计学意义（P〈0．05）。治疗组两次住院期间hs～CRP和LDL—C水平的变化显著优于对照组（P〈0．01）。结论瑞舒伐他汀能够降低晚期支架贴壁不良的发生率，减轻非特异性炎症反应，降低LDL—C水平。

Objective To investigate the correlation between rosuvastatin and late stent malapposition （LSM）.Methods 63 cases of patients were divided into treatment group and control group,35 patients in treatment group were continu- ously taken rosuvastatin administration 10 mg qd before and after percutaneous coronary implantation （PCI）.28 patients in control group were not taken rosuvastatin or taken rosuvastatin administration 10 mg qd less than 4 weeks.All cases were performed intravascular ultrasound （IVUS） immediately after PCI.And they were reexamined IVUS and angiogra- phy in 6-9 month after PCI.Serum high-sensitivity C-reactive protein （hs-CRP） and low density lipoprotein cholesterol （LDL-C） were tested during in-hospital.Results Three patients appeared LSM in treatment group,a total of 4 places.By contrast,eight patients were examined LSM in control group,a total of 13 places;two groups had significant difference （P〈0.05）; Increase the area of the external elastic membrane,the membrane increase the area,reducing the area of the lumen,intimal hyperplasia cross-sectional area in treatment group was less than that of the control group respectively （P〈O.05）.The changes of hs-CRP and LDL-C levels in treatment group were more obvious than those in control group （P〈0.01）.Conclusion Rosuvastatin can decrease the incidence of LSM.It also can alleviate the level of inflammatory factor and blood lipid.