不同剂量阿托伐他汀对急性冠状动脉综合征患者行经皮冠状动脉介入术后疗效及炎症因子的影响

The influence of different doses of atorvastatin on efficacy and inflammatory factors after percutaneous coronary intervention for patients with acute coronary syndrome

目的探讨不同剂量阿托伐他汀对急性冠状动脉综合征患者行经皮冠状动脉介入（PCI）术后疗效及炎症因子的影响。方法选取2012年1月～2013年8月择期行PCI术的急性冠状动脉综合征患者102例,随机分为阿托伐他汀钙10 mg组（A组）和20 mg组（B组）,每组51例。在患者择期行PCI术前、术后抽血测患者血脂[总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和三酰甘油（TG）]和炎症因子[超敏C反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）、白细胞介素-6（IL-6）]水平,记录术后30、180 d时主要心脏不良事件发生情况。结果 A、B两组在PCI术前后TC、LDL-C、TG比较,差异无统计学意义（P〉0.05）;组内PCI术后与术前比较,差异有统计学意义（P〈0.05）。A、B两组血清TNF-α、IL-6、hs-CRP术前比较,差异无统计学意义（P〉0.05）,术后7、30 d差异有统计学意义（P〈0.05）。两组主要心脏不良事件发生率比较,差异无统计学意义（P〉0.05）。结论急性冠状动脉综合征患者行择期PCI术时两种剂量的阿托伐他汀均安全有效,均能明显降低术后炎症因子水平,抗炎作用可独立于降脂作用以外。

Objective To investigate the influence of different doses of atorvastatin on efficacy and inflammatory factors after percutaneous coronary intervention（PCI） for patients with acute coronary syndrome. Methods 102 patients with acute coronary syndrome undergoing PCI surgery in our hospital from January 2012 to August 2013 were selected and randomly divided into 10 mg atorvastatin calcium group（group A） and 20 mg atorvastatin calcium group（group B）,51 cases in each group.Before and after PCI,serum lipid [total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）and triglyceride（TG）] and inflammatory cytokines [high-sensitivity C-reactive protein（hs-CRP）,tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）] level was measured,the incidence of major adverse cardiac events postoperative 30 d and 180 d were recorded. Results There was no significant difference about TC,LDL-C,TG between group A and group B before and after PCI operation（P〉0.05）;There was significant difference after PCI operation compared with before PCI operation in each group（P〈0.05）.There was no significant difference about TNF-α,IL-6,hs-CRP in group A and group B before PCI operation（P〉0.05）;there was significant difference after 7 d and 30 d PCI operation（P〈0.05）.There was no significant difference on rate of major adverse cardiac event between the two groups（P〉0.05）. Conclusion Two doses of atorvastatin is safe and effective in patients with acute coronary syndrome undergoing PCI,can significantly decrease the level of inflammatory factors after PCI operation,but independent of the lipid-lowering effect outside.