强化瑞舒伐他汀对行PCI的非ST段抬高型急性冠脉综合征患者的作用

Effect of strengthening rosuvastatin treatment on the patients with non-ST-segment elevation acute coronary syndromes treated with PCI

目的探讨强化瑞舒伐他汀治疗对行经皮冠状动脉介入治疗(PCI)的非ST段抬高型急性冠脉综合征患者的作用。方法将入院初步诊断为冠心病非ST段抬高型急性冠状动脉综合征且符合该试验条件的患者随机分为强化组和常规剂量组,强化组自入院起连续服用瑞舒伐他汀20 mg/d直至术后1月,1月后改为常规剂量10 mg/d;常规剂量组自入院时即给予常规剂量瑞舒伐他汀10 mg/d直至随访结束。观察两组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高敏C反应蛋白(hs-CRP)、肌钙蛋白(cTnT)、肌酸激酶-同工酶(CK-MB)水平以及术后3个月内主要心脏不良事件的发生情况。结果两组基础情况和冠状动脉造影特征无明显差异;两组患者术前hs-CRP、cTnT、CK-MB基线值差异无统计学意义(P>0.05)。术后24h、术后7d及术后1月两组血浆hs-CRP峰值差异有统计学意义(P<0.05);术后24h、术后7d两组血浆cTnT、CK-MB水平差异有统计学意义(P<0.05);术后1月两组血浆cTnT、CK-MB水平差异无统计学意义(P>0.05)。术后3个月内强化组无心脏不良事件发生,而常规剂量组有4例,差异有统计学意义(P<0.05)。结论行PCI的非ST段抬高型急性冠脉综合征患者给予强化瑞舒伐他汀治疗能明显降低术后血浆hs-CRP、cTnT、CK-MB水平,并减少术后心血管事件的发生。

Objective To investigate the effect of strengthening rosuvastatin treatment on the patients with non-ST-segment elevation acute coronary syndromes treated with percutaneous coronary intervention（PCI）. Methods Patients admitted to hospital because of preliminary diagnosed as non-ST-segment elevation acute coronary syndrome and met the trial criteria were randomly divided into strength group and routine-dose group; strengthen group was administrated with rosuvastatin 20 mg/d since admitted to hospital until one month after surgery, and then changed to 10 mg/d; routine dose group was given rosuvastatin 10 mg/d from the time admitted to hospital till the end of follow-up. Results There was no significant differences between two groups in the basic conditions and characteristics of coronary angiography. Before surgery, two groups of patients had no significant differences in baseline value of hs-CRP, cTnT and CK-MB（P〈0.05）. 24 hours after surgery, 7 days after surgery and one month after surgery, the peak values of plasma hs-CRP were all had significant differences between two groups（P〈0.05）. 24 hours after surgery and seven days after surgery, the levels of plasma cTnT and CK-MB had significance differences between two groups（P〈0.05）. One month after surgery, there was no significant difference between two groups in the levels of plasma cTnT and CK-MB（P〈0.05）. Strengthen group had no major adverse cardiac events within three months after surgery, while the routine dose group had four cases; the difference was statistically significant. Conclusion Strengthen rosuvastatin treatment on patients with non-ST-segment elevation acute coronary syndrome after PCI could significantly reduce the level of postoperative plasma hs-CRP, cTnT, CK-MB and the incidence of postoperative cardiovascular events.