经皮冠状动脉介入治疗术前强化他汀治疗在非ST段抬高的急性冠脉综合征患者中的安全性分析

Security analysis of intensive statins treatment before PCI in patients with non-ST-elevated acute coronary syndrome

目的：对比分析不同剂量的他汀治疗在非 ST 段抬高的急性冠脉综合征患者中的安全性。方法入选欲行冠状动脉造影检查及经皮冠状动脉介入治疗（PCI）的非 ST 段抬高的急性冠脉综合征（ACS）患者15例，随机分为强化治疗组（7例）和常规治疗组（8例）。强化治疗组：PCI 术前给予阿托伐他汀80 mg/ d，连用2 d，术后阿托伐他汀40 mg/ d，直至术后30 d，此后阿托伐他汀20 mg/ d 维持治疗；常规治疗组一开始即给予阿托伐他汀10~20 mg，每晚睡前口服，分别于 PCI 术前、术后第2天、术后（30±3）d、术后（90±7）d、术后（180±7）d 等时间点采血查丙氨酸氨基转移酶（ALT）、总胆红素（TBiL）、肌酐（Cr）（术后90、180 d 未查）、肌酸激酶（CK）。结果强化治疗组只有术后30 d 的 TBiL 值较常规治疗组明显增高，但是呈一过性。其余指标在各个时间点两组间比较差异均无统计学意义（P 〉0.05）。结论介入治疗术前强化他汀治疗在非 ST 段抬高的急性冠脉综合征患者中是安全的。

Objective To analyze the security of different doses statins treatment before PCI in patients with non ST elevation acute coronary syndrome. Methods Fifteen patients with non-ST-elevation acute coronary artery diseases scheduled for PCI were selected. These patients were randomly divided into two groups：intensive treatment group（7 cases）and conventional treatment group（8 cases）. Patients in intensive treatment group were given atorvastatin 80 mg/ d for 2 days before PCI,then 40 mg/ d for 30 days after PCI,then 20 mg/ d for long. Patients in conventional treatment group were given atorvastatin 10 - 20 mg orally,ev-ery night,from start to finish. For the two groups,before PCI,and 2 d,（30 ± 3）d,（90 ± 7）d,（80 ± 7）d after PCI,the ser-um level of ALT,TBiL,Cr（except 90,180 days after PCI）,CK were detected. Results Only TBiL of 30 days after PCI in in-tensive statins treatment group was higher than that in convenional treatment group（P = 0. 002）,but it was transient. There were no significant differences in other indexes at any time points between the two groups（P 〉 0. 05）. Conclusion Intensive statins treatment before PCI in patients with non-ST-elevation acute coronary syndrome is secure.